Individual
ERIC TODD SIMOLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1453 E BERT KOUNS INDUSTRIAL LOOP STE 319, SHREVEPORT, LA 71105-6800
(318) 681-1968
(318) 681-1969
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 606-6400
(903) 606-1522
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.A10318
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1624918
—
LA
Enumeration date
07/25/2006
Last updated
01/24/2024
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