| NPI | 1225002124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH NIDA Medical Director 318-377-8260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2023-04-26 |