DANZELL FAMILY MEDICAL CLINIC NPI 1134548175

NPI Information

DANZELL FAMILY MEDICAL CLINIC is a general practice in Shreveport, LA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DANZELL FAMILY MEDICAL CLINIC NPI is 1134548175. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2500 KINGS HWY
SHREVEPORT, LA
ZIP 71103-922
Phone: (318) 631-4030
Fax: (318) 631-4031

The provider's authorized official is John Davis Danzell .
The authorized official title is Medical Doctor and has the following contact phone number (318) 631-4030.

The CLIA number assigned to this NPI record is 19D0710774 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/7/2014 and was last updated on 4/7/2014.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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