Organization
PRACTICEMD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE BYRD (C.O.O.)
(318) 841-4312
Entity
Organization
Contact information
Practice address
242 LYNBROOK BLVD, SHREVEPORT, LA 71106-6548
(318) 841-4312
(318) 841-4342
Mailing address
PO BOX 6657, SHREVEPORT, LA 71136-6657
(318) 841-4312
(318) 841-4342
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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