# OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508522558
- **Legal business name:** OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC
- **Authorized official:** VERNON MOORE (CFO)
- **Authorized official phone:** (318) 626-0990

## Contact information

- **Practice address:** 1 SAINT MARY PL, SHREVEPORT, LA 71101-4307
- **Practice address phone:** (318) 626-4300
- **Mailing address:** 1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
- **Mailing address phone:** (318) 626-0284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/15/2021
- **Last updated:** 11/15/2021