| NPI | 1386238525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY FORTENBERRY Nurse Practitioner 318-458-2583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-02-28 |
| Last Update Date | 2021-03-01 |