Individual
MATHEW W STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5948 N MARKET ST, SHREVEPORT, LA 71107-2017
(318) 375-0001
(318) 375-0002
Mailing address
5948 N MARKET ST, SHREVEPORT, LA 71107-2017
(318) 375-0001
(318) 375-0002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200215
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1960497
—
LA
Enumeration date
11/21/2008
Last updated
11/04/2025
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