Individual
EMERSON THOMAS DOTSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 N MARKET ST, SHREVEPORT, LA 71107-6537
(131) 862-6559
(318) 626-5597
Mailing address
1500 N MARKET ST, SHREVEPORT, LA 71107-6537
13186265597
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
2203782947
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851741722
—
LA
Enumeration date
05/24/2017
Last updated
05/24/2017
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