Healthcare Provider Details

I. General information

NPI: 1790966638
Provider Name (Legal Business Name): MOREHOUSE GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 W WALNUT AVE
BASTROP LA
71220-4521
US

IV. Provider business mailing address

PO BOX 1060
BASTROP LA
71221-1060
US

V. Phone/Fax

Practice location:
  • Phone: 318-283-3600
  • Fax: 318-239-8600
Mailing address:
  • Phone: 318-283-3710
  • Fax: 318-239-8710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELMORE PATTERSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 318-283-3607