MEDICARE: D & D COMMUNITY CONNECTIONS

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	305R00000X	Preferred Provider Organization	9097	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477723484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D & D COMMUNITY CONNECTIONS

Provider Business Mailing Address
First Line	:	1041 N 9TH ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5548
Country	:	US
Telephone Number	:	318-651-0201
Fax Number	:	318-651-0221

Provider Business Practice Location Address
First Line	:	1041 N 9TH ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5548
Country	:	US
Telephone Number	:	318-651-0201
Fax Number	:	318-651-0221

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DIANN BECKWITH
Credential	:
Telephone Number	:	318-651-0201

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	03/05/2008

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Directions to “D & D COMMUNITY CONNECTIONS ” Practice Location

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