NPI 1063717841
Practicemd, INC.
Practice location
- Address
- 242 Lynbrook Blvd, Shreveport, LA 71106-6548
- Phone
- (318) 841-4312
- Fax
- (318) 841-4342
- Mailing address
- PO Box 6657, Shreveport, LA 71136-6657
Authorised official
- Name
- Mike Byrd
- Title
- C.O.O.
- Phone
- (318) 841-4312
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1063717841
- Entity type
- Organization
- NPI issued
- 25 Jan 2011
- Record last updated
- 25 Jan 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.