Organization
MID-CITY FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL SHANE CARR M.D. (OWNER/DOCTOR)
(318) 221-3525
Entity
Organization
Contact information
Practice address
838 MARGARET PL, SHREVEPORT, LA 71101-4509
(318) 221-3525
Mailing address
PO BOX 629, HAUGHTON, LA 71037-0629
(318) 221-3525
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
LA
Other
Enumeration date
10/26/2007
Last updated
07/21/2022
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