Organization
ARK-LA-TEX FERTILITY & REPRODUCTIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID T VANDERMOLEN M.D. (DIRECTOR)
(318) 344-4045
Entity
Organization
Contact information
Practice address
2401 GREENWOOD RD, SHREVEPORT, LA 71103-4010
(318) 344-4045
Mailing address
2401 GREENWOOD RD, SHREVEPORT, LA 71103-4010
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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