Individual
DR. NESLIHAN GUNGOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PEDIATRICS, SHREVEPORT, LA 71103-4228
(318) 675-6076
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-7636
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
204834
LA
2080P0205X
Pediatric Endocrinology Physician
204834
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2162896
—
LA
01
—
4Q543F600
MEDICARE PTAN
LA
Enumeration date
09/16/2008
Last updated
10/11/2011
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