Organization
DESOTO HOSPITAL ASSOCIATION
Active
Other names
DeSoto Regional Family Medicine-Mansfield
Organization subpart
No
Provider details
NPI number
Authorized official
HALLIE DEUTSCH (CREDENTIALING SPECIALIST)
(318) 871-3101
Entity
Organization
Contact information
Practice address
130 JEFFERSON ST, MANSFIELD, LA 71052-2602
(318) 872-2700
(318) 872-6214
Mailing address
130 JEFFERSON ST, MANSFIELD, LA 71052-2602
(318) 872-2700
(318) 872-6214
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
229RHC-3
LA
Other
Enumeration date
01/12/2012
Last updated
05/04/2020
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