Organization
OVERTON BROOKS VETERANS HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD MOORE (ASST. ADMINSTRATOR)
(318) 221-2411
Entity
Organization
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 429-5727
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
Z20148
LA
Other
Enumeration date
07/08/2011
Last updated
07/08/2011
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