Individual
EMILY BLYTHE PHIFER MENEFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1602 KINGS HWY DEPT OF PEDIATRIC ENDOCRINOLOGY, SHREVEPORT, LA 71103-4128
(318) 626-2269
(318) 675-6145
Mailing address
1602 KINGS HWY DEPT OF, SHREVEPORT, LA 71103-4128
(318) 626-2269
(318) 675-6145
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200556
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2314092
—
LA
Enumeration date
09/10/2012
Last updated
06/21/2022
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