Ark-La-Tex Spine Apmc
Pain Medicine, Interventional Pain Medicine in Shreveport, LA. Organization (NPI-2).
NPI number1851737506
StatusActive
Last updated in NPPESMay 12, 2016
Details
- NPI
- 1851737506
- Entity type
- Organization (NPI-2)
- Legal business name
- Ark-La-Tex Spine Apmc
- Organization subpart
- No
- Enumeration date
- May 21, 2013
- Last updated
- May 12, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | MD020437 | LA | Yes |
Practice location
8660 Fern AveSuite 120
Shreveport, LA 71105-5649
Phone 903-487-2248 · Fax 903-487-2306
Mailing address
Po Box 837Howe, TX 75459-0837
Phone 903-487-2248 · Fax 903-487-2306
Authorized official
Jefferey Adair
Owner
9034872248
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