Provider Demographics
NPI:1013303056
Name:DHP OF LOUISIANA PC
Entity Type:Organization
Organization Name:DHP OF LOUISIANA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTZCLAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-655-1338
Mailing Address - Street 1:808 AVIATION PARKWAY
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6600
Mailing Address - Country:US
Mailing Address - Phone:919-655-1338
Mailing Address - Fax:919-655-1330
Practice Address - Street 1:211 4TH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8421
Practice Address - Country:US
Practice Address - Phone:864-275-5049
Practice Address - Fax:919-655-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty