Doctor Name: | DR. HARRY MOBLEY |
NPI Number: | 1952382483 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 011669 |
Business Practice Address: | 3342 Bienville Rd Ringgold, LA - 710683242 |
Business Phone Number: | 3188943644 |
Business Fax Number: | 3189322186 |
Mailing Address: | 417 Southaven Ln, SHREVEPORT |
State: | LA |
Postal Code: | 711068391 |
Phone Number: | 3187983627 |
Fax Number: | 3189322186 |
NPI Enumeration Date: | 11/10/2005 |
NPI Last Update Date: | 04/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 011669 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |