Provider Demographics
NPI:1770559965
Name:OVERBY, JOHN LEON (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LEON
Last Name:OVERBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:165 BEECH SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-2013
Mailing Address - Country:US
Mailing Address - Phone:318-259-4435
Mailing Address - Fax:318-395-4291
Practice Address - Street 1:121 WATTS ST
Practice Address - Street 2:SUITE F
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-2062
Practice Address - Country:US
Practice Address - Phone:318-395-3051
Practice Address - Fax:318-395-3052
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA009015207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1094315Medicaid
LA1094315Medicaid