Organization
HIGHLAND CLINIC, A PROF MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE W. SMITH (ADMINISTRATOR)
(318) 798-4598
Entity
Organization
Contact information
Practice address
1455 E BERT KOUNS LOOP, SHREVEPORT, LA 71105-5634
(318) 798-4500
(318) 798-4555
Mailing address
1455 E BERT KOUNS LOOP, SHREVEPORT, LA 71105-5634
(318) 798-4500
(318) 798-4555
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071428901
—
TX
05
—
1038300
—
LA
05
—
108413002
—
AR
Enumeration date
06/09/2005
Last updated
04/01/2025
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