# NORTH LOUISIANA INTERNAL MEDICINE

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

## Provider details

- **NPI number:** 1942584123
- **Authorized official:** CHARLES P WEDRNER M.D. (PHYSICIAN)
- **Authorized official phone:** (318) 673-8320

## Contact information

- **Practice address:** 2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 400, SHREVEPORT, LA 71118-3133
- **Practice address phone:** (318) 673-8320
- **Practice address fax:** (318) 681-7975
- **Mailing address:** 2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 400, SHREVEPORT, LA 71118-3133
- **Mailing address phone:** (318) 673-8320
- **Mailing address fax:** (318) 681-7975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | LA | Yes |

## Other

- **Enumeration date:** 10/05/2011
- **Last updated:** 02/17/2017