| Lsuhsc-s Department Of Surgery | |
|
1501 Kings Hwy Lsuhsc-s Department Of Surgery Shreveport LA 71103-4228 | |
| (318) 675-7737 | |
| (318) 675-5666 |
| Full Name | Lsuhsc-s Department Of Surgery |
|---|---|
| Speciality | Surgery |
| Location | 1501 Kings Hwy, Shreveport, Louisiana |
| Authorized Official Name and Position | Melanie Hardegree Sotak (DIRECTOR OF MANAGED CARE) |
| Authorized Official Contact | 3186757737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lsuhsc-s Department Of Surgery 1501 Kings Hwy Lsuhsc-s Department Of Surgery Shreveport LA 71103-4228 Ph: (318) 675-7737 | Lsuhsc-s Department Of Surgery 1501 Kings Hwy Lsuhsc-s Department Of Surgery Shreveport LA 71103-4228 Ph: (318) 675-7737 |
| NPI Number | 1104860121 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 12/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104860121 | NPI | - | NPPES |
| 1798771 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 142 (Louisiana) | Secondary |
| 208600000X | Surgery | 142 (Louisiana) | Primary |
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