Healthcare Provider Details

I. General information

NPI: 1144063264
Provider Name (Legal Business Name): NORTH CADDO MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 LA-1
OIL CITY LA
71061
US

IV. Provider business mailing address

PO BOX 792
VIVIAN LA
71082-0792
US

V. Phone/Fax

Practice location:
  • Phone: 318-375-4008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID JONES
Title or Position: CEO
Credential:
Phone: 318-375-4008