Individual
GERALD BRENT WHITTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2510 BERT KOUNS INDUSTRIAL LOOP STE 215, SHREVEPORT, LA 71118-3119
(318) 212-5970
(318) 212-5975
Mailing address
PO BOX 3038, SHREVEPORT, LA 71133-3038
(318) 212-5970
(318) 212-5975
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
024459
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1572179
—
LA
Enumeration date
07/07/2006
Last updated
06/17/2021
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