Provider Demographics
NPI:1427208420
Name:SANSONS FAMILY MEDICINE INC
Entity Type:Organization
Organization Name:SANSONS FAMILY MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:V
Authorized Official - Last Name:SANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-397-7000
Mailing Address - Street 1:2309 ARKANSAS RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7820
Mailing Address - Country:US
Mailing Address - Phone:318-397-7000
Mailing Address - Fax:318-737-7203
Practice Address - Street 1:2309 ARKANSAS RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7820
Practice Address - Country:US
Practice Address - Phone:318-397-7000
Practice Address - Fax:318-737-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207Q00000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAI40065Medicare UPIN