Organization
DAVID PRICE MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID THOMAS PRICE M.D. (OWNER)
(318) 469-5606
Entity
Organization
Contact information
Practice address
1 SAINT MARY PL, SHREVEPORT, LA 71101-4343
(318) 469-5605
Mailing address
610 CHAMBORD CIR, SHREVEPORT, LA 71115-4615
(318) 469-5606
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
20511
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1430412
—
LA
01
—
7582155
AETNA
—
Enumeration date
07/25/2007
Last updated
08/23/2007
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