NPI 1619353802

Harris Memorial Pediatric & Family Clinic

Organisation Point of Service Shreveport, LA

Practice location

Address: 4571 N Market St, Shreveport, LA 71107-2917
Phone: (318) 934-0097
Fax: (318) 934-0097
Mailing address: PO Box 7312, Shreveport, LA 71137-7312

Authorised official

Name: Richard L Jackson
Title: Cheif Executive Office
Phone: (318) 205-4075

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

Other Point of Service providers in Louisiana →

Registry record

NPI: 1619353802
Entity type: Organization
NPI issued: 10 Aug 2015
Record last updated: 10 Aug 2015

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.