Organization
DESOTO HOSPITAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD EPPLER (CEO)
(318) 872-4610
Entity
Organization
Contact information
Practice address
207 JEFFERSON ST, MANSFIELD, LA 71052-2603
(318) 872-4610
(318) 872-1502
Mailing address
207 JEFFERSON ST, MANSFIELD, LA 71052-2603
(318) 872-4610
(318) 872-1502
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
282N00000X
General Acute Care Hospital
Primary
229
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04700
BLUE CROSS
—
05
—
119678402
—
TX
05
—
1743283
—
LA
05
—
1750131
—
LA
01
—
90118
BLUE CROSS
—
Enumeration date
05/27/2005
Last updated
07/09/2021
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