MEDICARE: JAMES FORD MHS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1013421056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES FORD MHS

Provider Business Mailing Address
First Line	:	404 HEARNE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71103-2022
Country	:	US
Telephone Number	:	318-716-1369
Fax Number	:	318-675-0120

Provider Business Practice Location Address
First Line	:	404 HEARNE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71103
Country	:	US
Telephone Number	:	318-716-1369
Fax Number	:	318-675-0120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2017
Last Update Date	:	12/17/2025

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