Individual
DR. CLIFTON W. SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8660 FERN AVE, SUITE 145, SHREVEPORT, LA 71105-5649
(337) 280-9200
Mailing address
PO BOX 53668, LAFAYETTE, LA 70505-3668
(337) 280-9200
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
014211
LA
207L00000X
Anesthesiology Physician
Primary
014211
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1186155
—
LA
Enumeration date
05/26/2007
Last updated
03/06/2009
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