| Desoto Hospital Assocation | |
|
808 Main St Logansport LA 71049-2605 | |
| (318) 697-2273 | |
| Not Available |
| Full Name | Desoto Hospital Assocation |
|---|---|
| Speciality | Family Medicine |
| Location | 808 Main St, Logansport, Louisiana |
| Authorized Official Name and Position | Christopher Davis (VP OF FINIANCE) |
| Authorized Official Contact | 3188722700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desoto Hospital Assocation 808 Main St Logansport LA 71049-2605 Ph: (318) 697-2273 | Desoto Hospital Assocation 808 Main St Logansport LA 71049-2605 Ph: (318) 697-2273 |
| NPI Number | 1205457892 |
|---|---|
| Provider Enumeration Date | 05/05/2020 |
| Last Update Date | 05/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205457892 | NPI | - | NPPES |
| 11445932 | Medicaid | LA | |
| 5C630 | Other | LA | NON MEDICARE RHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Desoto Reginal Family Medicine - Logansport Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 808 Main Street, Logansport, LA 71049 Phone: 318-697-2273 Fax: 318-697-2277 |