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Bogalusa Family Practice
General Practice Physician in Bogalusa, Louisiana
NPI 1104084839

Bogalusa Family Practice is a General Practice Physician based in Bogalusa, LA. Bogalusa Family Practice practices in Bogalusa, LA. The NPI Number for Bogalusa Family Practice is 1104084839 and holds a License No. MD107924 (Louisiana).

The current practice location address for Bogalusa Family Practice is 433 Plaza St, Bogalusa, LA and can be reached out via phone at 985-735-1198.

Location: 433 Plaza St, Bogalusa, LA, 70429-0700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104084839
Provider Name
Bogalusa Family Practice
Credential
Provider Entity Type
Organization
Address
433 Plaza St, Bogalusa, LA, 70429-0700
Phone Number
985-735-1198
Fax Number
Provider Enumeration Date
05/29/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1365858 05 LA
institution
Provider Business Practice Location Address Details
Address
433 Plaza St
City
Bogalusa
State
Louisiana
Zip
70427-3729
Phone Number
985-735-1198
Fax Number
person
Provider Business Mailing Address Details
Address
433 Plaza St
City
Bogalusa
State
Louisiana
Zip
70427-3729
Phone Number
985-735-1198
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
MD107924 (Louisiana)
Definition
Definition to come...
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