Provider Demographics
NPI:1720198138
Name:HEALING HANDS FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:HEALING HANDS FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELITA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:WILIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-686-7109
Mailing Address - Street 1:6821 PINES RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2547
Mailing Address - Country:US
Mailing Address - Phone:318-686-7109
Mailing Address - Fax:318-687-7016
Practice Address - Street 1:6821 PINES RD
Practice Address - Street 2:SUITE 400
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2547
Practice Address - Country:US
Practice Address - Phone:318-686-7109
Practice Address - Fax:318-687-7016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1706281Medicaid
1750383618OtherNPI