Individual
JOHN A LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.025680
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1044059
—
LA
01
—
4P273F600
MEDICARE - PTAN
LA
Enumeration date
08/31/2006
Last updated
04/03/2024
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