Individual
HARRY CARMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2911 FREDERICK ST, SHREVEPORT, LA 71109-3511
(318) 906-5054
Mailing address
2911 FREDERICK ST, SHREVEPORT, LA 71109-3511
(318) 906-5054
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
008105720
LA
Other
Enumeration date
06/22/2026
Last updated
06/22/2026
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