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NPI Code Detail

MEDICARE: TOTAL HEALTH FAMILY MEDICINE

MEDICARE: TOTAL HEALTH FAMILY MEDICINE
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
12080A0000XPediatric Adolescent Medicine Physician
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1962970582
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL HEALTH FAMILY MEDICINE
Provider Business Mailing Address
First Line : 2533 BERT KOUNS INDUSTRIAL LOOP STE 106
Second Line :
City : SHREVEPORT
State : LA
Zip : 71118-3158
Country : US
Telephone Number : 318-686-3770
Fax Number : 318-686-3838
Provider Business Practice Location Address
First Line : 2533 BERT KOUNS INDUSTRIAL LOOP STE 106
Second Line :
City : SHREVEPORT
State : LA
Zip : 71118-3158
Country : US
Telephone Number : 318-686-3770
Fax Number : 318-686-3838
Authorized Official
Title or Position : ADMINISTRATOR
Name : JASMINE NORRIS
Credential :
Telephone Number : 318-686-3770
Provider Enumeration Date : 11/13/2018
Last Update Date : 05/04/2026

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1831118983 — DARRELL I JOBE, JAMES M COTTON, ET AL MBR
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1902828148 — DR. ANDREW W PORTER DDS
Practice Location Address:
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Directions to “TOTAL HEALTH FAMILY MEDICINE ” Practice Location

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