Organization
TAAJ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY GLASGOW (CREDENTIALING)
(469) 640-4264
Entity
Organization
Contact information
Practice address
2525 VIKING DR, BOSSIER CITY, LA 71111-2103
(318) 841-2525
Mailing address
PO BOX 19022, SHREVEPORT, LA 71149-0022
(469) 640-4264
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
08/30/2025
Last updated
09/01/2025
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