| Thomas Rodsuwan M D Pmc | |
|
2525 Viking Drive Bossier City LA 71111-2058 | |
| (318) 841-2525 | |
| Not Available |
| Full Name | Thomas Rodsuwan M D Pmc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2525 Viking Drive, Bossier City, Louisiana |
| Authorized Official Name and Position | Thomas C. Rodsuwan (PRESIDENT) |
| Authorized Official Contact | 3184294930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Rodsuwan M D Pmc 9630 Norris Ferry Rd Shreveport LA 71106-7720 Ph: (318) 212-7830 | Thomas Rodsuwan M D Pmc 2525 Viking Drive Bossier City LA 71111-2058 Ph: (318) 841-2525 |
| NPI Number | 1710221361 |
|---|---|
| Provider Enumeration Date | 11/20/2012 |
| Last Update Date | 03/07/2016 |
| Medicare PECOS PAC ID | 6305081779 |
|---|---|
| Medicare Enrollment ID | O20130408000226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710221361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 022753 (Louisiana) | Primary |
| Provider Name | Tom C Rodsuwan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124111539 PECOS PAC ID: 7113007980 Enrollment ID: I20080107000206 |
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