Organization
SHREVEPORT DOCTORS' HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KIRK (CHIEF FINANCIAL OFFICER)
(318) 678-4206
Entity
Organization
Contact information
Practice address
1130 LOUISIANA AVE, SHREVEPORT, LA 71101-3908
(318) 227-1211
Mailing address
PO BOX 676689, DALLAS, TX 75267-6689
(972) 705-5134
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1749150
—
LA
Enumeration date
05/29/2007
Last updated
08/22/2020
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