Individual
DR. GENTRY LEE HAUGHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
592 UNADILLA ST, SHREVEPORT, LA 71106-1240
(318) 519-7555
Mailing address
PO BOX 5237, SHREVEPORT, LA 71135-5237
(318) 798-4539
(318) 798-4601
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
200048
LA
213ES0103X
Foot & Ankle Surgery Podiatrist
T07-2010
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
T13-2009
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
T24-2008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2158210
—
LA
Enumeration date
05/05/2009
Last updated
07/18/2024
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