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NPI Code Detail

MEDICARE: DESOTO HOSPITAL ASSOCIATION

MEDICARE: DESOTO HOSPITAL ASSOCIATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1273R00000XPsychiatric Hospital Unit

General Provider Information

NPI Number : 1578632766
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESOTO HOSPITAL ASSOCIATION
Provider Business Mailing Address
First Line : 207 JEFFERSON ST
Second Line :
City : MANSFIELD
State : LA
Zip : 71052-2603
Country : US
Telephone Number : 318-872-4610
Fax Number : 318-872-1502
Provider Business Practice Location Address
First Line : 207 JEFFERSON ST
Second Line :
City : MANSFIELD
State : LA
Zip : 71052-2603
Country : US
Telephone Number : 318-872-4610
Fax Number : 318-872-1502
Authorized Official
Title or Position : CEO
Name : MR. SCOTT STAFFORD
Credential :
Telephone Number : 318-872-4610
Provider Enumeration Date : 11/06/2006
Last Update Date : 08/22/2020

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Directions to “DESOTO HOSPITAL ASSOCIATION ” Practice Location

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