| Southern Pediatric Clinic | |
|
4571 N Market St Shreveport LA 71107-2917 | |
| (318) 934-0097 | |
| Not Available |
| Full Name | Southern Pediatric Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4571 N Market St, Shreveport, Louisiana |
| Authorized Official Name and Position | Stella Grace Immanuel (MD) |
| Authorized Official Contact | 3187309760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Pediatric Clinic 4571 N Market St Shreveport LA 71107-2917 Ph: (318) 934-0097 | Southern Pediatric Clinic 4571 N Market St Shreveport LA 71107-2917 Ph: (318) 934-0097 |
| NPI Number | 1508237256 |
|---|---|
| Provider Enumeration Date | 10/07/2015 |
| Last Update Date | 10/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508237256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD12866R (Louisiana) | Primary |
Hs Louisiana, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Kings Hwy, Suite 5-303, Shreveport, LA 71103 Phone: 904-834-2679 Fax: 904-395-3249 | |
Wk Digestive Disease Consultants Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2508 Bert Koun Loop, Sutie 304, Shreveport, LA 71118 Phone: 318-671-8880 Fax: 318-671-8879 | |
Andrew Dentino Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2551 Greenwood Rd, Suite 310, Shreveport, LA 71103 Phone: 318-212-8780 Fax: 318-212-8181 | |
Paul S Wilson Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1666 E Bert Kouns Industrial Loop, Suite 230, Shreveport, LA 71105 Phone: 318-212-3970 Fax: 318-212-3975 | |
Maurie Patterson Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8001 Youree Dr, Suite 400, Shreveport, LA 71115 Phone: 318-212-3456 Fax: 318-212-3885 | |
Raymond A. Coghlan Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2551 Greenwood Rd, Suite 150, Shreveport, LA 71103 Phone: 318-631-9996 Fax: 318-631-9345 | |
Shreveport Family Medicine Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7505 Pines Road, Suite 1250, Shreveport, LA 71129 Phone: 318-686-3770 Fax: 318-686-3838 |