| Organization Name: | DANZELL FAMILY MEDICAL CLINIC |
| NPI Number: | 1134548175 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN DAVIS DANZELL (MEDICAL DOCTOR) |
| Mailing Address: | 2500 Kings Hwy Shreveport |
| State: | LA US |
| Postal Code: | 711033922 |
| Phone Number: | 3186314030 |
| Fax Number: | 3186314031 |
| NPI Enumeration Date: | 04/07/2014 |
| NPI Last Update Date: | 04/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 013603 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |