Organization
COLON & RECTAL ASSOCIATES PC
Active
Organization
COLON & RECTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. W. REID GRIMES M.D. (VICE PRESIDENT)
(318) 424-8373
Entity
Organization
Contact information
Practice address
1811 E BERT KOUNS STE 430, SHREVEPORT, LA 71105-5741
(318) 424-8373
(318) 424-6477
Mailing address
1811 E BERT KOUNS STE 430, SHREVEPORT, LA 71105-5741
(318) 424-8373
(318) 424-6477
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071416401
—
TX
05
—
1107913
—
LA
Enumeration date
06/29/2006
Last updated
07/21/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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