Organization
LOUISIANA PAIN PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY M. SMITH (CHIEF FINANCIAL OFFICER)
(318) 861-1336
Entity
Organization
Contact information
Practice address
457 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7229
(318) 861-1260
(318) 861-1325
Mailing address
457 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7229
(318) 861-1260
(318) 861-1325
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG1274
RAILROAD MEDICARE
LA
Enumeration date
02/19/2007
Last updated
08/27/2009
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