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General NPI Number Information
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NPI Number | 1417370909
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Entity Type | Organization
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Legal Business Name | WEST OUACHITA FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 3057 HIGHWAY 80 W
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City | CALHOUN
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State | LA
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Zip | 71225-7907
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Country | US
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Telephone | 318-644-5838
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Fax | 318-644-5836
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Provider Business Mailing Address
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Address Line | 3057 HIGHWAY 80 W
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City | CALHOUN
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State | LA
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Zip | 71225-7907
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Country | US
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Telephone | 318-644-5838
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Fax | 318-644-5836
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN RAY HANCOCK
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Credential |
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Telephone | 318-644-5838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 2203783685
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License Number State | LA
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