Southern Medical Services of Louisiana, LLC

NPI #1225453335 in Bastrop, Louisiana

Provider Information

NPI Number
1225453335
Entity Type
Organization
Organization Name
Southern Medical Services of Louisiana, LLC
Primary Specialty
Nurse Practitioner
Enumeration Date
Feb 26, 2014
Last Updated
Feb 26, 2014

Practice Location

Address
1523 TEXAS AVE
ZIP Code
71220-4043
Phone
(318) 281-0078

Authorized Official

Name
MR. CHARLES G GLADNEY
Title
OWNER
Phone
(318) 281-0078

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner

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