Organization
J. GARY BOOKER, MD, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. GARY BOOKER MD (PRESIDENT)
(318) 227-9600
Entity
Organization
Contact information
Practice address
851 OLIVE ST, SHREVEPORT, LA 71104-2136
(318) 227-9600
(318) 227-9601
Mailing address
851 OLIVE ST, SHREVEPORT, LA 71104-2136
(318) 227-9600
(318) 227-9601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD017803
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013916642
NPI-INDIVIDUAL
LA
05
—
1901750
—
LA
Enumeration date
07/30/2007
Last updated
07/30/2007
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