Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE
Active
Organization
LSU HEALTH SCIENCES CENTER SHREVEPORT FACULTY GROUP PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITZI GREEN (DIRECTOR)
(318) 626-0000
Entity
Organization
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0284
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207T00000X
Neurological Surgery Physician
—
NULL
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
Other
Enumeration date
01/19/2016
Last updated
06/28/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers