Organization
AWASON MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IDONGESIT A. UMOETTE (CEO)
(318) 703-9122
Entity
Organization
Contact information
Practice address
7505 PINES RD, STE 1255, SHREVEPORT, LA 71129-3923
(318) 703-9122
Mailing address
7505 PINES RD, STE 1255, SHREVEPORT, LA 71129-3923
(318) 703-9122
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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