| North Caddo Hospital Service District | |
|
112 Forest Street Plain Dealing LA 71064-3446 | |
| (318) 326-7272 | |
| Not Available |
| Full Name | North Caddo Hospital Service District |
|---|---|
| Speciality | Family Medicine |
| Location | 112 Forest Street, Plain Dealing, Louisiana |
| Authorized Official Name and Position | David Jones (CEO) |
| Authorized Official Contact | 3183754001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Caddo Hospital Service District 112 N Forrest Rd Plain Dealing LA 71064-4031 Ph: (318) 326-7272 | North Caddo Hospital Service District 112 Forest Street Plain Dealing LA 71064-3446 Ph: (318) 326-7272 |
| NPI Number | 1477798668 |
|---|---|
| Provider Enumeration Date | 12/03/2008 |
| Last Update Date | 10/30/2020 |
| Medicare PECOS PAC ID | 4385544584 |
|---|---|
| Medicare Enrollment ID | O20090327000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477798668 | NPI | - | NPPES |
| 2302639 | Medicaid | LA | |
| 1444286 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02439R (Louisiana) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Wk Plain Dealing Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 N Louisiana St, Plain Dealing, LA 71064 Phone: 318-326-7272 Fax: 318-326-7282 |