Individual
ANDREW LONG CHESSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF NEUROLOGY, SHREVEPORT, LA 71103-4228
(318) 675-5241
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-5241
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
04134R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1183130
—
LA
01
—
4A796F600
MEDICARE - PTAN
LA
Enumeration date
07/09/2006
Last updated
01/15/2014
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