Organization
SHREVEPORT PRIME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE M JURGELSKY MD (PRESIDENT)
(318) 402-2333
Entity
Organization
Contact information
Practice address
1513 LINE AVE # 240, SHREVEPORT, LA 71101-4621
(318) 402-2333
Mailing address
1513 LINE AVE # 240, SHREVEPORT, LA 71101-4621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017289
LA
Other
Enumeration date
05/12/2009
Last updated
05/12/2009
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