Individual
BRIAN T DILLON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 GREENWOOD RD, SHREVEPORT, LA 71103-3908
(318) 212-4500
(318) 212-4143
Mailing address
PO BOX 32600, SHREVEPORT, LA 71130-2600
(318) 212-4877
(318) 212-4192
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13407R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1428485
—
LA
Enumeration date
08/15/2005
Last updated
07/08/2007
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