Individual
GAIL M AMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6821 PINES RD, SUITE 100, SHREVEPORT, LA 71129-2547
(318) 687-5500
(318) 687-5503
Mailing address
6821 PINES RD, SUITE 100, SHREVEPORT, LA 71129-2547
(318) 687-5500
(318) 687-5503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15174R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1168009
—
LA
Enumeration date
06/18/2006
Last updated
04/01/2009
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