NPI 1972803088 · live from the CMS NPI Registry
Jacquelyn E Adcock, P.A.
Physician Assistant in Bossier City, LA. National Provider Identifier 1972803088, active.
NPI record
| NPI | 1972803088 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 2539 Viking Dr, Suite 101, Bossier City, LA 71111 |
| Practice phone | 318-747-8100 |
| Enumerated | October 25, 2010 |
| Last updated | October 28, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | 200398 (LA) |
| Physician Assistant primary | 363A00000X | 200398 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.