Individual
KIRK W. COFRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520 BERT KOUNS LOOP, SUITE 102, SHREVEPORT, LA 71118-3130
(318) 688-0173
(318) 632-5369
Mailing address
2520 BERT KOUNS LOOP, SUITE 102, SHREVEPORT, LA 71118-3130
(318) 688-0173
(318) 632-5369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13472R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1569313
—
LA
Enumeration date
05/16/2006
Last updated
11/21/2007
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