Individual
MR. SAMSON BEKELE BESHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3118
Mailing address
402 GREEN BRIAR ST, APT 19, DERIDDER, LA 70634-2120
(678) 791-6125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5831
GA
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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