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General NPI Number Information
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NPI Number | 1972607505
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, ALEXANDRIA,LA
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/08/2008
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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 | 318-483-5060
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Provider Business Mailing Address
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Address Line | 6424 MOODY OAKS
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City | ALEXANDRIA
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State | LA
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Zip | 71301-2776
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Country | US
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Telephone | 318-445-8202
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Fax | 318-483-5060
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Authorized Official
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Title or Position | CHIEF OF PHYSICAL MEDICINE AND REHA
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Name | DR. FERDOUS ARA CHOUDHURY
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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 | 163958
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License Number State | NY
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