Healthcare Provider Details

I. General information

NPI: 1427665579
Provider Name (Legal Business Name): MOBILE MEDICAL MISSIONS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 PARKWAY DR STE A
NATCHITOCHES LA
71457-6276
US

IV. Provider business mailing address

1385 HIGHWAY 494
NATCHITOCHES LA
71457-2826
US

V. Phone/Fax

Practice location:
  • Phone: 318-228-9411
  • Fax: 318-352-2488
Mailing address:
  • Phone: 318-228-9411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LORI LEE RODRIGUEZ
Title or Position: PHYSICIAN/ADMINISTRATOR
Credential: MD
Phone: 318-228-9411