M. Craig Bozeman, M.D., a.P.M.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

019407 Issued in LA

Legal business name

M. CRAIG BOZEMAN, M.D., A.P.M.C.

Practice address

8001 Youree Dr
Ste 820
Shreveport, LA 71115-2302

Phone

(318) 798-3823

Fax

(318) 798-3887

NPI assigned

Oct 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Karen Cooper Johnson

Title

Office Manager

Phone

(318) 798-3823

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1972792851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "STE 820",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-798-3823",
            "fax_number": "318-798-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "STE 820",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-798-3823",
            "fax_number": "318-798-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. CRAIG BOZEMAN, M.D., A.P.M.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "COOPER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-798-3823",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "LA",
            "license": "019407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1978981",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.