Organization
DANZELL FAMILY MEDICAL CLINIC
Active
Parent organization
DANZELL FAMILY MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DANZELL FAMILY MEDICAL CLINIC
Authorized official
MR. JOHN DAVIS DANZELL JR. M.D. (MEDICAL DOCTOR)
(318) 631-4030
Entity
Organization
Contact information
Practice address
2500 KINGS HWY, SHREVEPORT, LA 71103-3922
(318) 631-4030
(318) 631-4031
Mailing address
2500 KINGS HWY, SHREVEPORT, LA 71103-3922
(318) 631-4030
(318) 631-4031
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
013603
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307891
—
LA
Enumeration date
04/07/2014
Last updated
04/07/2014
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