Organization
DR ALLEN J HERBERT A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN J HERBERT MD (OWNER)
(318) 255-7474
Entity
Organization
Contact information
Practice address
411 E VAUGHN AVE, SUITE 203, RUSTON, LA 71270-5972
(318) 255-7474
(318) 254-5278
Mailing address
PO BOX 1768, SHREVEPORT, LA 71166-1768
(318) 677-7450
(318) 425-5815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD010285
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1126403
—
LA
Enumeration date
04/19/2007
Last updated
11/12/2009
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