Provider Demographics
NPI:1609587997
Name:ARKLATEX MEDICAL CONSULTANTS A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ARKLATEX MEDICAL CONSULTANTS A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOAKUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-797-5848
Mailing Address - Street 1:8731 PARK PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5682
Mailing Address - Country:US
Mailing Address - Phone:318-797-5848
Mailing Address - Fax:318-797-5844
Practice Address - Street 1:1549 E 70TH ST STE 300
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5056
Practice Address - Country:US
Practice Address - Phone:318-300-3898
Practice Address - Fax:318-797-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies