Individual
AMANDA HAMMAD BUNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2508 BERT KOUN LOOP, SUITE 201, SHREVEPORT, LA 71118-3133
(318) 212-5790
(318) 212-5795
Mailing address
2508 BERT KOUN LOOP, SUITE 201, SHREVEPORT, LA 71118-3133
(318) 212-5790
(318) 212-5795
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
300655
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2188569
—
LA
Enumeration date
04/11/2012
Last updated
06/21/2021
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