Gibson Family Practice
LBN: Drg Medical Llc
Gibson Family Practice is an health care organization with primary practice located at 1549 Elizabeth Ave , Shreveport LA 71101-4501. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Ambulatory Health Care Facilities / Primary Care. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty.
Drg Medical Llc can be contacted via phone (318) 918-0058, or through Gibson, William Lee via phone (318) 918-0058.
Contact Information
Primary practice address
1549 Elizabeth Ave
Shreveport LA 71101-4501
Phone: (318) 918-0058
Fax:
Website:
Authorized official contact:
Name: Gibson, William Lee Doctor of Medicine (MD)
Phone: (318) 918-0058
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X |
Profile Details
| NPI number | 1316418288 |
|---|---|
| LBN Legal business name | Drg Medical Llc |
| DBA Doing business as | Gibson Family Practice |
| Authorized official | Gibson, William Lee Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 17th, 2018 |
| Last updated | Oct 26th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316418288 | NPPES |
| Louisiana | MEDICAID | 1509639 |
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