Organization
BANKAI PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM MOSSALLATI MD (OWNER)
(304) 203-5754
Entity
Organization
Contact information
Practice address
1111 LINE AVE, SHREVEPORT, LA 71101-3841
(318) 716-4770
(318) 716-4791
Mailing address
PO BOX 1684, SHREVEPORT, LA 71165-1684
(318) 424-6004
(866) 276-8064
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
03/20/2017
Last updated
11/21/2022
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