Organization
SHREVEPORT FAMILY MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELIA L. JACKSON (ADMINISTRATOR)
(318) 686-3770
Entity
Organization
Contact information
Practice address
7505 PINES ROAD, SUITE 1250, SHREVEPORT, LA 71129-3927
(318) 686-3770
(318) 686-3838
Mailing address
7505 PINES RD, SUITE 1250, SHREVEPORT, LA 71129-3935
(318) 686-3770
(318) 686-3838
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
12/06/2006
Last updated
06/16/2008
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