# NORTHEAST LOUISIANA PHYSICIANS, LLC

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

## Provider details

- **NPI number:** 1407637671
- **Authorized official:** LISHA FALK (VP OF CONTRACTING)
- **Authorized official phone:** (337) 609-1221

## Contact information

- **Practice address:** 2531 VIKING DR, BOSSIER CITY, LA 71111-2103
- **Practice address phone:** (318) 681-7000
- **Mailing address:** 200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
- **Mailing address phone:** (800) 893-9698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/12/2023
- **Last updated:** 01/03/2024