Organization
GPN-LEESVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BEDDOE (CEO)
(318) 256-5691
Entity
Organization
Contact information
Practice address
1020 W FERTITTA BLVD, LEESVILLE, LA 71446
(337) 239-9041
Mailing address
PO BOX 722345, NORMAN, OK 73070-8774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
07/23/2018
Last updated
07/30/2018
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