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Organization

BENTON MEDICAL CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IRAM K ZANDO MD (MD/OWNER)
(318) 798-4539
Entity
Organization

Contact information

Practice address
188 BURT BLVD, BENTON, LA 71006-4900
(318) 798-4539
(318) 798-4601
Mailing address
PO BOX 52364, SHREVEPORT, LA 71135-2364
(318) 798-4664
(318) 798-4457

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
09509R
LA

Other

Enumeration date
07/31/2013
Last updated
07/31/2013
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