Organization
CHOICE PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLABODE O DESALU MD (OWNER)
(318) 290-3673
Entity
Organization
Contact information
Practice address
6930 FERN AVE, SUITE 150, SHREVEPORT, LA 71105-4100
(318) 290-3673
(318) 290-3672
Mailing address
PO BOX 5866, SHREVEPORT, LA 71135-5866
(318) 290-3673
(318) 290-3672
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15345R
LA
Other
Enumeration date
09/08/2011
Last updated
12/29/2011
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