Organization
MOBILE FOOT SPECIALIST, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASSELL HUDSON DPM (PODIATRIC PHYSICIAN)
(318) 797-4169
Entity
Organization
Contact information
Practice address
2855 LONG LAKE DR, SHREVEPORT, LA 71106
(318) 797-4169
(318) 797-4169
Mailing address
P.O. BOX 52834, SHREVEPORT, LA 71135
(318) 797-4169
(318) 797-4169
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PD149R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982698023
NPI
LA
05
—
1993085
—
LA
Enumeration date
10/01/2007
Last updated
06/11/2010
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