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General NPI Number Information
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NPI Number | 1861576183
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Entity Type | Organization
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Legal Business Name | VETERANS ADMINISTRATION MEDICAL CENTER
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2495 SHREVEPORT HWY
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City | PINEVILLE
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State | LA
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Zip | 71360-4044
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Country | US
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Telephone | 318-473-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 6156 SCHULTZ ROAD
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City | CROWLEY
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State | LA
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Zip | 70526
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Country | US
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Telephone | 337-783-6038
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. STEPHEN CHARLES FITZGERALD
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Credential | M.D.
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Telephone | 318-473-0010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 12019R
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License Number State | LA
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