Individual
SOPHIA TAYEBEH SHOKOUH-AMIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1327 PIERRE AVE, SHREVEPORT, LA 71103
(318) 212-8624
(318) 226-8545
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8951
(318) 212-6752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
311260
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387707
—
LA
Enumeration date
04/23/2015
Last updated
02/19/2019
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