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General NPI Number Information
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NPI Number | 1720237787
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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 | 09/15/2008
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 7045 YOUREE DR
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City | SHREVEPORT
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State | LA
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Zip | 71105-5108
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Country | US
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Telephone | 225-363-2193
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Fax | 225-363-2276
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Provider Business Mailing Address
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Address Line | PO BOX 2064
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-2064
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Country | US
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Telephone | 225-363-2193
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Fax | 225-363-2276
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | LESLIE OAKES
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Credential |
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Telephone | 318-798-3763
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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 | DO.000012
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License Number State | LA
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