Provider Demographics
NPI:1073861837
Name:JOSHUA R CASON LIMITED APMC
Entity Type:Organization
Organization Name:JOSHUA R CASON LIMITED APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CASON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-423-4385
Mailing Address - Street 1:PO BOX 53032
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71135-3032
Mailing Address - Country:US
Mailing Address - Phone:318-932-2081
Mailing Address - Fax:318-932-2215
Practice Address - Street 1:1110 RINGGOLD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:COUSHATTA
Practice Address - State:LA
Practice Address - Zip Code:71019-9073
Practice Address - Country:US
Practice Address - Phone:318-932-2081
Practice Address - Fax:318-932-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2140086Medicaid
LADU2283OtherRR MEDICARE GROUP
LADU2283OtherRR MEDICARE GROUP