Organization
INTERNAL MEDICAL ASSOCIATES OF DOCTORS HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD KEITH COX (AUTHORIZED REPRESENTATIVE)
(318) 425-3130
Entity
Organization
Contact information
Practice address
128 LOUISIANA AVE, SHREVEPORT, LA 71101-2754
(318) 425-3130
Mailing address
128 LOUISIANA AVE, SHREVEPORT, LA 71101-2754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114430
—
LA
Enumeration date
05/02/2006
Last updated
07/21/2022
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