Organization
EXCELLENCE PHYSICIAN BILLING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLADYS T BUSH (BILLING AGENT)
(318) 773-0657
Entity
Organization
Contact information
Practice address
9501 CHASE WAY, SHREVEPORT, LA 71118-4619
(318) 773-0657
(318) 688-0326
Mailing address
PO BOX 19284, SHREVEPORT, LA 71149-0284
(318) 773-0657
(318) 688-0326
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Enumeration date
09/18/2009
Last updated
09/18/2009
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