| J.j.burgin, MD, LLC | |
|
1032 Lochinvar Ln Shreveport LA 71106-8172 | |
| (562) 569-1601 | |
| Not Available |
| Full Name | J.j.burgin, MD, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1032 Lochinvar Ln, Shreveport, Louisiana |
| Authorized Official Name and Position | Jode Jann Burgin (OWNER) |
| Authorized Official Contact | 5625691601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J.j.burgin, MD, LLC 1032 Lochinvar Ln Shreveport LA 71106-8172 Ph: (562) 569-1601 | J.j.burgin, MD, LLC 1032 Lochinvar Ln Shreveport LA 71106-8172 Ph: (562) 569-1601 |
| NPI Number | 1003604240 |
|---|---|
| Provider Enumeration Date | 04/28/2025 |
| Last Update Date | 09/02/2025 |
| Certification Date | 05/02/2025 |
| Medicare PECOS PAC ID | 3577073436 |
|---|---|
| Medicare Enrollment ID | O20250610001410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003604240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Jode Jann Burgin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053541565 PECOS PAC ID: 9234385097 Enrollment ID: I20150901000396 |
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