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General NPI Number Information
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NPI Number | 1932246378
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Entity Type | Organization
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Legal Business Name | DESOTO HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 2026 OBRIE STREET
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City | ZWOLLE
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State | LA
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Zip | 71486-1339
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Country | US
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Telephone | 318-645-6013
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Fax |
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Provider Business Mailing Address
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Address Line | 2026 OBRIE STREET PO BOX 1339
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City | ZWOLLE
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State | LA
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Zip | 71486-1339
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Country | US
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Telephone | 318-645-6013
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CHRISTOPHER DAVIS
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Credential |
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Telephone | 318-270-3250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice 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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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