Clhg-Ruston LLC
General Practice in Ruston, LA. Organization (NPI-2).
NPI number1245964931
StatusActive
Last updated in NPPESSep 6, 2022
Details
- NPI
- 1245964931
- Entity type
- Organization (NPI-2)
- Legal business name
- Clhg-Ruston LLC
- Organization subpart
- No
- Enumeration date
- Jul 11, 2022
- Certification date
- Sep 2, 2022
- Last updated
- Sep 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 207RP1001X | Internal Medicine, Pulmonary Disease | – | – | |
| 261Q00000X | Clinic/Center | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Other names
- Ruston Physician Practices (Doing Business As)
Practice location
401 E Vaughn AveRuston, LA 71270-5950
Phone 318-254-2100
Mailing address
401 E Vaughn AveRuston, LA 71270-5950
Phone 318-254-2453
Authorized official
Rock Matthew Bordelon
Owner
3186293269
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