Individual
DR. SRINIVAS POTTURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
189 CAPTAIN H.M BLVD., SHREVEPORT, LA 71115
(318) 459-7557
(318) 459-7557
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD.200712
LA
Other
Enumeration date
09/13/2006
Last updated
07/09/2007
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