| Bellah Medical, Llc | |
|
1801 Fairfield Ave Suite 409 Shreveport LA 71101-4443 | |
| (318) 841-2801 | |
| (318) 841-2800 |
| Full Name | Bellah Medical, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1801 Fairfield Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | Lloyd D Bellah (OWNER) |
| Authorized Official Contact | 3188412801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellah Medical, Llc 1801 Fairfield Ave. Suite 409 Shreveport LA 71104 Ph: (318) 841-2801 | Bellah Medical, Llc 1801 Fairfield Ave Suite 409 Shreveport LA 71101-4443 Ph: (318) 841-2801 |
| NPI Number | 1154561223 |
|---|---|
| Provider Enumeration Date | 03/02/2009 |
| Last Update Date | 03/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154561223 | NPI | - | NPPES |
| 1539384 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 12606R (Louisiana) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | K0260 (Texas) | Secondary |
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