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Organization

JUDITH B. NANCE, M.D. LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TINA DEWITT BAILEY (OFFICE MANAGER)
(318) 561-9600
Entity
Organization

Contact information

Practice address
1135 EXPRESSWAY DR, SUITE 200 A, PINEVILLE, LA 71360-6698
(318) 561-9600
(318) 561-0228
Mailing address
1135 EXPRESSWAY DR, SUITE 200 A, PINEVILLE, LA 71360-6698
(318) 561-9600
(318) 561-0228

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.14759R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1438154
LA
Enumeration date
10/05/2007
Last updated
10/05/2007
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