# GENTRY HAUGHTON LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245503119
- **Authorized official:** DR. GENTRY LEE HAUGHTON DPM (PODIATRIST)
- **Authorized official phone:** (318) 519-7555

## Contact information

- **Practice address:** 592 UNADILLA ST, SHREVEPORT, LA 71106-1240
- **Practice address phone:** (318) 519-7555
- **Mailing address:** PO BOX 5237, SHREVEPORT, LA 71135-5237
- **Mailing address phone:** (318) 519-7555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 200048 | LA | Yes |

## Other

- **Enumeration date:** 02/22/2012
- **Last updated:** 07/18/2024