Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
LSUHSC-S Department of Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELANIE HARDEGREE SOTAK MHSA (DIRECTOR OF MANAGED CARE)
(318) 675-7737
Entity
Organization
Contact information
Practice address
1501 KINGS HWY, LSUHSC-S DEPARTMENT OF SURGERY, SHREVEPORT, LA 71103-4228
(318) 675-7737
(318) 675-5666
Mailing address
1501 KINGS HWY, LSUHSC-S DEPARTMENT OF SURGERY, SHREVEPORT, LA 71103-4228
(318) 675-7737
(318) 675-5666
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
142
LA
208600000X
Surgery Physician
Primary
142
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1798771
—
LA
Enumeration date
06/16/2006
Last updated
12/27/2007
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