Organization
NEUROLOGY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJEEVI C. TIVAKARAN M.D. (CEO)
(318) 741-2900
Entity
Organization
Contact information
Practice address
2400 HOSPITAL DRIVE, SUITE 310, BOSSIER CITY, LA 71111
(318) 741-2900
(318) 741-2999
Mailing address
2400 HOSPITAL DRIVE, SUITE 310, BOSSIER CITY, LA 71111
(318) 741-2900
(318) 741-2999
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
11838R
LA
Other
Enumeration date
09/29/2006
Last updated
09/25/2008
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