Organization
POWELL MEDICAL CENTER MINISTISTRIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT H POWELL MD (PHYSICIAN)
(318) 221-4471
Entity
Organization
Contact information
Practice address
515 PIERRE AVE, SHREVEPORT, LA 71101-2445
(318) 221-4471
(318) 221-4913
Mailing address
515 PIERRE AVE, SHREVEPORT, LA 71101-2445
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
L012949
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1140376
—
LA
Enumeration date
01/03/2007
Last updated
08/22/2020
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