Mills Clinic A Professional Medical Corporation

LBN: Mills Clinic A Professional Medical Corporation
Mills Clinic A Professional Medical Corporation is an health care organization with primary practice located at 7225 Fern Avenue Suite 600, Shreveport LA 71105-4981. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Mills Clinic A Professional Medical Corporation can be contacted via phone (318) 629-3630, or through Mills, Bryan Haywood via phone (318) 629-3630.

Contact Information

Primary practice address
7225 Fern Avenue Suite 600 Shreveport LA 71105-4981
Fax: (318) 629-3640
Website:
Authorized official contact:
Name: Mills, Bryan Haywood Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1649328030
LBN Legal business name Mills Clinic A Professional Medical Corporation
DBA Doing business as
Authorized official Mills, Bryan Haywood Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 8th, 2007
Last updated Oct 14th, 2008 - about 18 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 1649328030 NPPES
Louisiana MEDICAID 1989088
Louisiana Other 19D1047971

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