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General NPI Number Information
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NPI Number | 1659639995
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Entity Type | Organization
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Legal Business Name | DOCTORS MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 3769 PONTCHARTRAIN DR SUITE 1
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City | SLIDELL
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State | LA
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Zip | 70458-4852
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Country | US
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Telephone | 985-288-4181
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Fax | 985-288-5127
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Provider Business Mailing Address
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Address Line | 3769 PONTCHARTRAIN DR SUITE 1
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City | SLIDELL
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State | LA
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Zip | 70458-4852
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Country | US
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Telephone | 985-288-4181
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Fax | 985-288-5127
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/MANAGER
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Name | WILLIAM FRANKLIN YOST
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Credential |
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Telephone | 985-288-4181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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