Organization
CLHG-RUSTON LLC
Active
Other names
Allegiance Medical Clinic Northside Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY M HALL (CEO)
(318) 254-2450
Entity
Organization
Contact information
Practice address
1402 CELEBRITY DR, RUSTON, LA 71270-3878
(318) 255-1515
(318) 255-6590
Mailing address
1402 CELEBRITY DR, RUSTON, LA 71270-3878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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