Organization
SOUTHSIDE FOOT CLINIC OF SHREVEPORT, INC. A PROFESSIONAL CORPORATION
Active
Other names
Southside Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD TAYLOR HAVENS D.P.M. (PHYSICIAN/ADMINISTRATOR)
(318) 687-6266
Entity
Organization
Contact information
Practice address
9308 MANSFIELD RD, STE 100, SHREVEPORT, LA 71118-3134
(318) 687-6266
(318) 683-1023
Mailing address
9308 MANSFIELD RD, STE 100, SHREVEPORT, LA 71118-3134
(318) 687-6266
(318) 683-1023
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5B496
LA
Other
Enumeration date
06/01/2005
Last updated
12/29/2025
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