Individual
JAMES WILLIAM SIKES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
6912 FERN LOOP STE A, SHREVEPORT, LA 71105-4176
(318) 585-7667
(318) 585-6912
Mailing address
6912 FERN LOOP STE A, SHREVEPORT, LA 71105-4176
(318) 585-7667
(318) 585-6912
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
11117
GA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4912
LA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
024422
LA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
51272
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467912
UCCI
LA
05
—
1849120
—
LA
Enumeration date
08/01/2006
Last updated
08/20/2019
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