Organization
DESOTO HOSPITAL ASSOCATION
Active
Other names
DeSoto Regional Family Medicine Clinic-Logansport, DeSoto Regional Family Medicine - Logansport
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DAVIS (VP OF FINIANCE)
(318) 872-2700
Entity
Organization
Contact information
Practice address
808 MAIN ST, LOGANSPORT, LA 71049-2605
(318) 697-2273
Mailing address
808 MAIN ST, LOGANSPORT, LA 71049-2605
(318) 697-2273
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11445932
—
LA
01
—
5C630
NON MEDICARE RHC
LA
Enumeration date
05/05/2020
Last updated
10/08/2025
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