| Applegate | |
|
1605 Benton Rd Suite D Bossier City LA 71111-3578 | |
| (318) 742-0500 | |
| (318) 742-0588 |
| Full Name | Applegate |
|---|---|
| Speciality | Family Medicine - Addiction Medicine |
| Location | 1605 Benton Rd, Bossier City, Louisiana |
| Authorized Official Name and Position | Philip Isherwood (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3187420500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Applegate 1605 Benton Rd Suite D Bossier City LA 71111-3578 Ph: (318) 742-0500 | Applegate 1605 Benton Rd Suite D Bossier City LA 71111-3578 Ph: (318) 742-0500 |
| NPI Number | 1437393162 |
|---|---|
| Provider Enumeration Date | 04/24/2009 |
| Last Update Date | 06/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437393162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Primary |
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