Individual
DR. LAWRENCE GALE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, OTOLARYNGOLOGY/HNS, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
007896
LA
207YX0901X
Otology & Neurotology Physician
3843
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1621072
—
LA
01
—
4J587F600
MEDICARE - PTAN
LA
Enumeration date
12/01/2005
Last updated
03/13/2014
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