Individual
MS. MARIBETH FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
2800 HEARNE AVE, SHREVEPORT, LA 71103-3934
(318) 663-5208
Mailing address
2800 HEARNE AVE, SHREVEPORT, LA 71103-3934
(318) 212-6086
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1073752
LA
Other
Enumeration date
09/27/2006
Last updated
08/09/2022
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