| NPI | 1134548175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVIS DANZELL Medical Doctor 318-631-4030 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: LA 013603) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-04-07 |