# HEALTHPLEX FAMILY CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053495374
- **Authorized official:** MS. MARIE M BAKER (PRACTICE MANAGER)
- **Authorized official phone:** (318) 683-5171

## Contact information

- **Practice address:** 9425 HEALTHPLEX DR, SUITE 101, SHREVEPORT, LA 71106-8148
- **Practice address phone:** (318) 683-5171
- **Practice address fax:** (318) 683-5184
- **Mailing address:** 9425 HEALTHPLEX DR, SUITE 101, SHREVEPORT, LA 71106-8148
- **Mailing address phone:** (318) 683-5171
- **Mailing address fax:** (318) 683-5184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 022545 | LA | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1447099 | — | LA |