MEDICARE: YOLONDA DOTSON

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	:	1053764696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLONDA DOTSON

Provider Business Mailing Address
First Line	:	2800 YOUREE DR STE 120
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-3667
Country	:	US
Telephone Number	:	318-562-6271
Fax Number	:	318-562-6263

Provider Business Practice Location Address
First Line	:	2800 YOUREE DR STE 120
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-3667
Country	:	US
Telephone Number	:	318-671-4341
Fax Number	:	318-220-4039

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

Provider Enumeration Date	:	07/19/2016
Last Update Date	:	01/07/2020

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Directions to “ YOLONDA DOTSON ” Practice Location

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