| Vincent D. Mallory Md., Llc | |
|
3311 Prescott Rd Suite 316 Alexandria LA 71301-3900 | |
| (318) 487-1717 | |
| (318) 487-1170 |
| Full Name | Vincent D. Mallory Md., Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3311 Prescott Rd, Alexandria, Louisiana |
| Authorized Official Name and Position | Constance Fisher Mallory (OFFICE MANGER) |
| Authorized Official Contact | 3184871717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vincent D. Mallory Md., Llc 3311 Prescott Rd Suite 316 Alexandria LA 71301-3900 Ph: (318) 487-1717 | Vincent D. Mallory Md., Llc 3311 Prescott Rd Suite 316 Alexandria LA 71301-3900 Ph: (318) 487-1717 |
| NPI Number | 1215201215 |
|---|---|
| Provider Enumeration Date | 03/08/2012 |
| Last Update Date | 03/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215201215 | NPI | - | NPPES |
| 1574520 | Medicaid | LA | |
| 1215918503 | Other | LA | NPI-INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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