Dr Fredric Thomas Siskron, MD | |
2915 Missouri Ave, Shreveport, LA 71109-4327 | |
(318) 364-2000 | |
Not Available |
Full Name | Dr Fredric Thomas Siskron |
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Gender | Male |
Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
Location | 2915 Missouri Ave, Shreveport, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023006590 | NPI | - | NPPES |
1920886 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 010722 (Louisiana) | Primary |
Entity Name | The Delta Pathology Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548258973 PECOS PAC ID: 4789639089 Enrollment ID: O20050321000139 |
Mailing Address | Practice Location Address |
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Dr Fredric Thomas Siskron, MD Po Box 731280, Dallas, TX 75373-1280 Ph: () - | Dr Fredric Thomas Siskron, MD 2915 Missouri Ave, Shreveport, LA 71109-4327 Ph: (318) 364-2000 |
Kshitij Satnamdas Arora, Pathology Medicare: Medicare Enrolled Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Fleurette Wilheimina Abreo, MBBS Pathology Medicare: Medicare Enrolled Practice Location: 2915 Missouri Ave, Shreveport, LA 71109 Phone: 318-621-8820 Fax: 318-212-4189 | |
Sara Samadzadeh, M.D Pathology Medicare: Medicare Enrolled Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 310-938-4285 | |
Dr. George K. Harrison, MD Pathology Medicare: Medicare Enrolled Practice Location: 2915 Missouri Ave, Shreveport, LA 71109 Phone: 318-364-2000 | |
Warren Donovan Grafton, M.D. Pathology Medicare: Medicare Enrolled Practice Location: 1501 Kings Hwy, Department Of Pathology, Shreveport, LA 71103 Phone: 318-675-7737 Fax: 318-675-5666 | |
Dr. Maria-magdalena Georgescu, M.D., PH.D. Pathology Medicare: Medicare Enrolled Practice Location: 1501 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-4929 |