Individual
BLAKELY NELSON THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 LINE AVE, SHREVEPORT, LA 71104-2126
(318) 226-9441
(318) 425-3236
Mailing address
2121 LINE AVE, SHREVEPORT, LA 71104-2126
(318) 226-9441
(318) 425-3236
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
207985
LA
Other
Enumeration date
04/15/2009
Last updated
06/22/2015
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