| Dr Allen J Herbert A Medical Corp | |
|
411 E Vaughn Ave Suite 203 Ruston LA 71270-5972 | |
| (318) 255-7474 | |
| (318) 254-5278 |
| Full Name | Dr Allen J Herbert A Medical Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 411 E Vaughn Ave, Ruston, Louisiana |
| Authorized Official Name and Position | Allen J Herbert (OWNER) |
| Authorized Official Contact | 3182557474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Allen J Herbert A Medical Corp Po Box 1768 Shreveport LA 71166-1768 Ph: (318) 677-7450 | Dr Allen J Herbert A Medical Corp 411 E Vaughn Ave Suite 203 Ruston LA 71270-5972 Ph: (318) 255-7474 |
| NPI Number | 1962629212 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 11/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962629212 | NPI | - | NPPES |
| 1126403 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD010285 (Louisiana) | Primary |
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