Organization
NORTH CADDO HOSPITAL SERVICE DISTRICT
Active
Parent organization
NORTH CADDO HOSPITAL SERVICE DISTRICT
Other names
NCMC Medical and Surgical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH CADDO HOSPITAL SERVICE DISTRICT
Authorized official
MR. DAKOTA ROBINSON (CFO)
(318) 375-4097
Entity
Organization
Contact information
Practice address
815 S PINE ST, VIVIAN, LA 71082-3353
(318) 375-4007
Mailing address
815 S PINE ST, VIVIAN, LA 71082-3353
(318) 375-4007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1038130
—
LA
Enumeration date
03/19/2018
Last updated
05/13/2022
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