Individual
DEBORAH JEAN WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF UROLOGY, SHREVEPORT, LA 71103-4228
(318) 813-2750
(318) 813-2755
Mailing address
1512 W KIRBY PL, DEPARTMENT OF UROLOGY, SHREVEPORT, LA 71103-3822
(318) 675-7636
(318) 675-7531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10426
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1624900
—
LA
01
—
5F600PE85
MEDICARE - PTAN
LA
Enumeration date
07/17/2006
Last updated
07/19/2011
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