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General NPI Number Information
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NPI Number | 1255680724
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Entity Type | Organization
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Legal Business Name | VELOCITY MD LLC
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 9300 MANSFIELD RD SUITE 110
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City | SHREVEPORT
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State | LA
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Zip | 71118-3137
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Country | US
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Telephone | 318-629-3763
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Fax | 318-629-3767
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Provider Business Mailing Address
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Address Line | PO BOX 15673
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City | LOVES PARK
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State | IL
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Zip | 61132-5673
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Country | US
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Telephone | 815-713-2600
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Fax | 815-654-8020
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Authorized Official
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Title or Position | OWNER/ URGENT CARE PHYSICIAN
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Name | DR. JOHN C SOUD
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Credential | DO
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Telephone | 318-629-3763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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