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Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Parent organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Other names
LSUHSC-S Clinics
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Authorized official
LEISA P OGLESBY (EXECUTIVE DIR FOR MEDICAL SERVICES)
(318) 675-7629
Entity
Organization
Contact information
Practice address
1501 KINGS HIGHWAY, LSUHSC-S CLINICS, SHREVEPORT, LA 71103-4228
(318) 603-8022
(318) 861-4029
Mailing address
PO BOX 735328, DALLAS, TX 75373-5328
(318) 603-8022
(318) 861-4029
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
05/05/2021
Last updated
05/05/2021
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