Individual
TED BROOX WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2394
(318) 212-7830
(318) 212-7835
Mailing address
2300 HOSPITAL DR, SUITE 200, BOSSIER CITY, LA 71111-2394
(318) 212-7830
(318) 212-7835
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
016886
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1357227
—
LA
Enumeration date
07/07/2006
Last updated
01/03/2008
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