| NPI | 1326236134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DEWITT BAILEY Office Manager 318-561-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.14759R) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |