Individual
MARJORIE R CHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-7636
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
205991
LA
208200000X
Plastic Surgery Physician
Primary
MD205991
LA
208200000X
Plastic Surgery Physician
N3553
TX
2086S0105X
Surgery of the Hand (Surgery) Physician
205991
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2324209
—
TX
01
—
276655YH54
MEDICARE - PTAN
LA
Enumeration date
01/11/2007
Last updated
03/18/2025
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