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Contact Information

ALFRED W. HATHORN JR., M.D. APMC
2120 BERT KOUN LOOP
SUITE # L
SHREVEPORT, LA71118-3351
 Phone: 318-686-8197
 Fax: 318-688-5962
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ALFRED W. HATHORN JR., M.D. APMC

NPI # 1487066296
LBN Legal business name ALFRED W. HATHORN JR., M.D. APMC
Authorized official RUTH HATHORN - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/28/2014
Last updated 05/28/2014 - About 12 years ago
Identifiers
LA License # 011400
LA License # AP06110
LA Medicaid 1135127
LA Medicaid 2315889
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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