NPI 1568714442

Diabetic Life Pulse of Louisiana, LLC

Organisation General Practice Physician Shreveport, LA

Practice location

Address: 8575 Fern Ave STE 110, Shreveport, LA 71105-5677
Phone: (318) 698-8889
Fax: (318) 698-8893

Authorised official

Name: Deborah K Adcock
Title: Medical Director
Phone: (318) 286-3296

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 08006R (LA)

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Registry record

NPI: 1568714442
Entity type: Organization
NPI issued: 3 Oct 2012
Record last updated: 4 Apr 2013

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.