Organization
ARKLATEX FERTILITY AND REPRODUCTIVE MEDICINE
Active
Organization
ARKLATEX FERTILITY AND REPRODUCTIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID VANDERMOLEN M.D. (DIRECTOR)
(318) 841-5800
Entity
Organization
Contact information
Practice address
2401 GREENWOOD RD, SUITE A, SHREVEPORT, LA 71103-4010
(318) 841-5800
(318) 841-5817
Mailing address
2401 GREENWOOD RD, SUITE A, SHREVEPORT, LA 71103-4010
(318) 841-5800
(318) 841-5817
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
AP0799
LA
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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