SOUTH BOSSIER MEDICAL – NPI #1649993585
Clinic/Center

SOUTH BOSSIER MEDICAL is an AHC clinic located in BOSSIER CITY, LA. NPPES has assigned the NPI number 1649993585 to SOUTH BOSSIER MEDICAL on September 26, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health

The NPI profile was last updated on Dec 09, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTH BOSSIER MEDICAL below.

NPI Profile for
SOUTH BOSSIER MEDICAL

NPI Number
1649993585
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTH BOSSIER MEDICAL
Primary location
5668 BARKSDALE BLVD
BOSSIER CITY, LA 71112
Phone: (318) 735-1800 Fax: (318) 725-4960
Mailing address
5260 BARKSDALE BLVD
BOSSIER CITY, LA 71112
Phone: Fax:
Organization Subpart
Yes - SOUTH BOSSIER MEDICAL is subpart of another organization.
Authorized Official
DAVID JONES
CEO
Phone: (318) 375-4001
Updated
Certification Date
Dec 09, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR1300X
- Clinic/Center / Rural Health (Primary)
261QP2300X
- Clinic/Center / Primary Care
207Q00000X
- Family Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.