Jct Medical/Russell W. Tynes Md

LBN: Jct Medical Consulting
Jct Medical/Russell W. Tynes Md is an health care organization with primary practice located at 460 Ashley Ridge Blvd Ste 500 , Shreveport LA 71106-7228. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Jct Medical Consulting can be contacted via phone (318) 212-1610, or through Tynes, Russell W. via phone (318) 212-1610.

Contact Information

Primary practice address
460 Ashley Ridge Blvd Ste 500 Shreveport LA 71106-7228
Phone: (318) 212-1610
Fax: (866) 455-7515
Website:
Map and Directions
Authorized official contact:
Name: Tynes, Russell W. Doctor of Medicine (MD)
Phone: (318) 212-1610

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 016884 Louisiana

Profile Details

NPI number 1205022647
LBN Legal business name Jct Medical Consulting
DBA Doing business as Jct Medical/Russell W. Tynes Md
Authorized official Tynes, Russell W. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 19th, 2007
Last updated Apr 29th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205022647 NPPES
Louisiana MEDICAID 1351661

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