Provider Demographics
NPI:1952531170
Name:CARDINAL CARE LLC
Entity Type:Organization
Organization Name:CARDINAL CARE LLC
Other - Org Name:RICHARD T. SIPES, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SIPES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-935-6177
Mailing Address - Street 1:8625 LINE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-6107
Mailing Address - Country:US
Mailing Address - Phone:318-935-6177
Mailing Address - Fax:888-935-4748
Practice Address - Street 1:8625 LINE AVE STE E
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-6107
Practice Address - Country:US
Practice Address - Phone:318-935-6177
Practice Address - Fax:888-935-4748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13289R207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty