Healthcare Provider Details

I. General information

NPI: 1457489593
Provider Name (Legal Business Name): DESOTO HOSPITAL ASSOCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 MAIN STREET
LOGANSPORT LA
71049
US

IV. Provider business mailing address

808 MAIN STREET
LOGANSPORT LA
71049
US

V. Phone/Fax

Practice location:
  • Phone: 318-697-2273
  • Fax: 318-697-2277
Mailing address:
  • Phone: 318-697-2273
  • Fax: 318-697-2277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateLA

VIII. Authorized Official

Name: HALLIE DEUTSCH
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 318-871-3101