Individual
DR. MARIO H LOBAO GONCALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
328121
LA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
328121
LA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
328121
LA
207XX0801X
Orthopaedic Trauma Physician
328121
LA
Other
Enumeration date
10/10/2017
Last updated
11/14/2024
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