Individual
JOEL BREVING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2924 KNIGHT ST STE 410, SHREVEPORT, LA 71105-2413
(859) 640-1727
Mailing address
2924 KNIGHT ST STE 410, SHREVEPORT, LA 71105-2413
(859) 640-1727
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
308040
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017683
PMP
LA
01
—
051144
CDS LICENSE
LA
Enumeration date
05/21/2007
Last updated
03/07/2023
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