Individual
KEVIN L WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1455 E BERT KOUNS LOOP, SUITE #100, SHREVEPORT, LA 71105-5634
(318) 798-4596
(318) 798-4520
Mailing address
1455 E BERT KOUNS LOOP, SUITE #100, SHREVEPORT, LA 71105-5634
(318) 798-4596
(318) 798-4520
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN134889
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298034401
—
TX
01
—
750818167015
TRICARE
TX
01
—
8398UC
BCBS
TX
Enumeration date
01/18/2012
Last updated
05/24/2013
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