Individual
NICHOLAS R STANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
159 FREMONT ST, SHREVEPORT, LA 71105-3028
(515) 505-0922
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
LA
Other
Enumeration date
01/02/2025
Last updated
06/27/2025
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