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Organization
GG MEDICAL
Active
Organization
GG MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THARWAT GHATTAS MD (OWNER)
(318) 207-3206
Entity
Organization
Contact information
Practice address
4900 MEDICAL DR, BOSSIER CITY, LA 71112-4521
(318) 747-9500
Mailing address
PO BOX 52133, SHREVEPORT, LA 71135-2133
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
02/25/2021
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