Individual
RAYMOND A. COGHLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2551 GREENWOOD RD, SUITE 150, SHREVEPORT, LA 71103-3981
(318) 631-9996
(318) 631-9345
Mailing address
2551 GREENWOOD RD, SUITE 150, SHREVEPORT, LA 71103-3981
(318) 631-9996
(318) 631-9345
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
018860
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1384003
—
LA
Enumeration date
05/09/2006
Last updated
11/21/2007
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