# DIABETIC LIFE PULSE OF LOUISIANA, LLC

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

## Provider details

- **NPI number:** 1568714442
- **Authorized official:** DEBORAH K ADCOCK MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (318) 286-3296

## Contact information

- **Practice address:** 8575 FERN AVE STE 110, SHREVEPORT, LA 71105-5677
- **Practice address phone:** (318) 698-8889
- **Practice address fax:** (318) 698-8893
- **Mailing address:** 8575 FERN AVE STE 110, SHREVEPORT, LA 71105-5677
- **Mailing address phone:** (318) 698-8889
- **Mailing address fax:** (318) 698-8893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 08006R | LA | Yes |

## Other

- **Enumeration date:** 10/03/2012
- **Last updated:** 04/04/2013