Organization
BOMBINAMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUYAH M LOUD-DOCKETT MD (OWNER)
(318) 946-8183
Entity
Organization
Contact information
Practice address
4140 HOLLYWOOD AVE, SUITE B-2, SHREVEPORT, LA 71109-7818
(318) 946-8183
Mailing address
4140 HOLLYWOOD AVE, SUITE B-2, SHREVEPORT, LA 71109-7818
(318) 946-8183
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
15815R
LA
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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