Healthcare Provider Details

I. General information

NPI: 1508947300
Provider Name (Legal Business Name): SOUTHERN EMERGENCY CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 MASONIC DR
ALEXANDRIA LA
71301-3841
US

IV. Provider business mailing address

3330 MASONIC DR
ALEXANDRIA LA
71301-3841
US

V. Phone/Fax

Practice location:
  • Phone: 318-793-5723
  • Fax:
Mailing address:
  • Phone: 318-793-5723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LARRY D. PARKER
Title or Position: PRESIDENT
Credential: MD
Phone: 318-793-5723