Individual
JACQUELYN E ADCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2539 VIKING DR, SUITE 101, BOSSIER CITY, LA 71111-1611
(318) 747-8100
(318) 747-8150
Mailing address
2539 VIKING DR, SUITE 101, BOSSIER CITY, LA 71111-1611
(318) 747-8100
(318) 747-8150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200398
LA
363A00000X
Physician Assistant
Primary
200398
LA
Other
Enumeration date
10/25/2010
Last updated
10/28/2020
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