Organization
DESOTO PHYSICIANS & SURGEONS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY L KENNEDY (DIRECTOR OF CLINICS PHYS SRCS)
(318) 872-4610
Entity
Organization
Contact information
Practice address
119 JEFFERSON ST, MANSFIELD, LA 71052-2601
(318) 872-5810
(318) 872-2763
Mailing address
119 JEFFERSON ST, PO BOX 739, MANSFIELD, LA 71052-2601
(318) 872-5810
(318) 872-2763
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
025688
LA
Other
Enumeration date
03/15/2007
Last updated
08/19/2008
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