| North Bossier Family Medicine | |
|
4707 Palmetto Rd Benton LA 71006-9712 | |
| (318) 965-9644 | |
| (318) 965-9640 |
| Full Name | North Bossier Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 4707 Palmetto Rd, Benton, Louisiana |
| Authorized Official Name and Position | Vicki S. Cobb (OWNER) |
| Authorized Official Contact | 3189659644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Bossier Family Medicine 4707 Palmetto Rd Benton LA 71006-9712 Ph: (318) 965-9644 | North Bossier Family Medicine 4707 Palmetto Rd Benton LA 71006-9712 Ph: (318) 965-9644 |
| NPI Number | 1457411837 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8921105594 |
|---|---|
| Medicare Enrollment ID | O20070515000543 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457411837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Vicki S Cobb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366470205 PECOS PAC ID: 0547287393 Enrollment ID: I20051031000793 |
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