Provider Demographics
NPI:1508822040
Name:DRS HART CARTER AND DEAN APMC
Entity Type:Organization
Organization Name:DRS HART CARTER AND DEAN APMC
Other - Org Name:WOMENS HEALTH ASSOCIATES OF NORTH LOUISIANA
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-742-5800
Mailing Address - Street 1:2400 HOSPITAL DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2385
Mailing Address - Country:US
Mailing Address - Phone:318-742-5800
Mailing Address - Fax:318-741-3902
Practice Address - Street 1:2400 HOSPITAL DR
Practice Address - Street 2:SUITE 240
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2385
Practice Address - Country:US
Practice Address - Phone:318-742-5800
Practice Address - Fax:318-741-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12326174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB60378Medicare UPIN