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General NPI Number Information
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NPI Number | 1710466628
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Entity Type | Organization
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Legal Business Name | ARKLATEX MEDICAL CONSULTANTS A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/10/2018
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 8731 PARK PLAZA DR
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City | SHREVEPORT
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State | LA
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Zip | 71105-5682
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Country | US
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Telephone | 318-797-5848
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Fax | 318-797-5844
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Provider Business Mailing Address
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Address Line | 8731 PARK PLAZA DR
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City | SHREVEPORT
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State | LA
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Zip | 71105-5682
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | NICOLE YOAKUM
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Credential |
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Telephone | 318-918-9859
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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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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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