Individual
MRS. HASCAL BOSSIER BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3330 MASONIC DRIVE, ALEXANDRIA, LA 71301-3899
(318) 448-6700
(318) 448-4925
Mailing address
3330 MASONIC DRIVE, ALEXANDRIA, LA 71301-3899
(318) 448-6700
(318) 448-4925
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200890
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2417835
—
LA
Enumeration date
02/15/2016
Last updated
06/24/2020
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