Individual
IVAN SKOCIBUSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT (R)
Contact information
Practice address
5552 NORTHWOOD SOUTH RD, SHREVEPORT, LA 71107-9263
(318) 205-2667
Mailing address
5552 NORTHWOOD SOUTH RD, SHREVEPORT, LA 71107-9263
(318) 205-2667
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
561226
LA
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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