Individual
MARY CHUMBLEY CROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1811 EAST BERT KOUNS, SUITE 400, SHREVEPORT, LA 71115-5741
(318) 212-3810
(318) 212-3815
Mailing address
1811 E BERT KOUNS INDUSTRIAL LOOP, SUITE 400, SHREVEPORT, LA 71105-5740
(318) 212-3810
(318) 212-3815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.204709
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106368
—
LA
Enumeration date
04/23/2010
Last updated
10/02/2013
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