NPI 1174304042

Abigail Davis Bogan, PAC

Practitioner Medical Physician Assistant Bossier City, LA

Practice location

Address: 5341 Airline Dr, Bossier City, LA 71111-6710
Phone: (318) 935-1820
Mailing address: 5341 Airline Dr STE 130, Bossier City, LA 71111-6710

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X

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Registry record

NPI: 1174304042
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Oct 2023
Record last updated: 20 Dec 2023

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.