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BRENTWOOD ACQUISITION SHREVEPORT INC NPI 1063644383


NPI Information

NPI: 1063644383
Provider Name: BRENTWOOD ACQUISITION SHREVEPORT, INC

Doing Business As: BRENTWOOD OUTPATIENT CLINIC

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
1002 HIGHLAND AVE
SUITE 200
SHREVEPORT, LA
ZIP 71101
Phone: (318) 222-6226
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BRENTWOOD ACQUISITION SHREVEPORT, INC is a medical specialty clinic center in Shreveport, LA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). BRENTWOOD ACQUISITION SHREVEPORT, INC NPI is 1063644383. The provider is registered as an organization entity type.
The provider Is Doing Business As Brentwood Outpatient Clinic.

The provider's business location address is:

1002 HIGHLAND AVE
SUITE 200
SHREVEPORT, LA
ZIP 71101-143
Phone: (318) 222-6226
Fax: (318) 222-6227

The provider's authorized official is Jodi Lynn Burns .
The authorized official title is Office Manager and has the following contact phone number (318) 222-6260.

The enumeration date for this NPI number is 8/20/2009 and was last updated on 8/20/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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