Provider Demographics
NPI:1992096226
Name:CLIF DOPSON, M.D. APMC
Entity type:Organization
Organization Name:CLIF DOPSON, M.D. APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:CLIFTON
Authorized Official - Last Name:DOPSON, M.D.
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:318-424-3867
Mailing Address - Street 1:610 HERNDON ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4704
Mailing Address - Country:US
Mailing Address - Phone:318-424-3867
Mailing Address - Fax:318-424-5006
Practice Address - Street 1:610 HERNDON ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4704
Practice Address - Country:US
Practice Address - Phone:318-424-3867
Practice Address - Fax:318-424-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0136042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty