Individual
JOEL ALACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
1501 KINGS HIGHWAY, INTERNAL MEDICINE, SHREVEPORT, LA 71103
(318) 626-0434
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
326956
LA
208M00000X
Hospitalist Physician
Primary
326956
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053825
CDS
LA
01
—
326956
STATE LICENSE
LA
Enumeration date
04/03/2018
Last updated
03/07/2023
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