Individual
DR. RODRICK ELLIS LOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2701 FREDERICK ST, SHREVEPORT, LA 71109-3607
(318) 631-3464
Mailing address
586 ONEONTA ST, SHREVEPORT, LA 71106-1620
(318) 349-0167
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1255
VI
1223G0001X
General Practice Dentistry
Primary
5534
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1855341
—
LA
Enumeration date
02/14/2007
Last updated
07/08/2007
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