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General NPI Number Information
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NPI Number | 1942751201
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Entity Type | Organization
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Legal Business Name | JENA BAND OF CHOCTAW INDIANS
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 906 LAPALI HINA ST
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City | TROUT
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State | LA
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Zip | 71371-3508
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Country | US
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Telephone | 318-992-2763
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Fax | 318-992-4162
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Provider Business Mailing Address
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Address Line | 906 LAPALI HINA ST
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City | TROUT
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State | LA
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Zip | 71371-4115
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Country | US
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Telephone | 318-992-2763
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Fax | 318-992-4162
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Authorized Official
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Title or Position | HEALTH DIRECTOR
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Name | TAMMY K DEASON
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Credential |
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Telephone | 318-992-2763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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