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General NPI Number Information
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NPI Number | 1437525367
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Entity Type | Organization
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Legal Business Name | GPN OAKDALE LLC
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Dates
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Enumeration Date | 08/14/2015
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 130 HOSPITAL DR
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City | OAKDALE
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State | LA
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Zip | 71463-3035
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Country | US
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Telephone | 318-335-3700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 721064
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City | NORMAN
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State | OK
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Zip | 73070-4822
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Country | US
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Telephone | 318-335-3700
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SAMUEL D HUCKABEE
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Credential |
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Telephone | 318-469-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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