Healing Grace Internal Medicine & Pediatrics, Llc

LBN: Healing Grace Internal Medicine & Pediatrics, Llc
Healing Grace Internal Medicine & Pediatrics, Llc is an health care organization with primary practice located at 6821 Pines Rd Suite 200, Shreveport LA 71129-2547. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Allergy & Immunology is the primary health care specialty. Healing Grace Internal Medicine & Pediatrics, Llc can be contacted via phone (318) 671-9309, or through Clayton, Tonya via phone (318) 671-9309.

Contact Information

Primary practice address
6821 Pines Rd Suite 200 Shreveport LA 71129-2547
Phone: (318) 671-9309
Fax: (318) 671-9311
Website:
Map and Directions
Authorized official contact:
Name: Clayton, Tonya Doctor of Medicine (MD)
Phone: (318) 671-9309

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 023335 Louisiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 023335 Louisiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 023335 Louisiana

Profile Details

NPI number 1780802504
LBN Legal business name Healing Grace Internal Medicine & Pediatrics, Llc
DBA Doing business as
Authorized official Clayton, Tonya Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 24th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780802504 NPPES
Louisiana MEDICAID 1494046

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