Provider Demographics
NPI:1518459700
Name:A PLUS MEDICAL OF RUSTON LLC
Entity Type:Organization
Organization Name:A PLUS MEDICAL OF RUSTON LLC
Other - Org Name:MICHAEL BROOKS FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-259-6200
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71273-0445
Mailing Address - Country:US
Mailing Address - Phone:318-436-2600
Mailing Address - Fax:318-436-2601
Practice Address - Street 1:612 S. FARMERVILLE STREET
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270
Practice Address - Country:US
Practice Address - Phone:318-680-8587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-04
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health