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Individual

LAUREN MITCHELL BEAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1501 KINGS HWY, DEPARTMENT OF MED&PEDS, SHREVEPORT, LA 71103
(318) 813-2528
(318) 813-2565
Mailing address
1501 KINGS HWY, DEPARTMENT OF MED&PEDS, SHREVEPORT, LA 71103-4228
(318) 813-2528
(318) 813-2565

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200123
LA
208000000X
Pediatrics Physician
200123
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1059668
LA
Enumeration date
06/04/2007
Last updated
08/20/2018
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