Individual
DAVID JEFFREY MOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 AVENUE F, BOGALUSA, LA 70427-3600
(985) 732-0058
(985) 732-0019
Mailing address
420 AVENUE F, BOGALUSA, LA 70427-3600
(985) 732-0058
(985) 732-0019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301407174
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080D17690
BLUE SHIELD
MI
05
—
3118953
—
MI
01
—
4098967
AETNA
MI
Enumeration date
06/14/2006
Last updated
04/07/2021
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