Individual
DR. KEVIN MARK MCGANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9425 HEALTHPLEX DR, SUITE 101, SHREVEPORT, LA 71106-8148
(318) 683-5171
(318) 683-5182
Mailing address
7607 FERN AVE STE 204, SHREVEPORT, LA 71105-5699
(318) 393-5980
(318) 683-5182
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
026369
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1562939
—
LA
01
—
4K328CD73
MEDICARE GROUP ID
LA
Enumeration date
07/12/2006
Last updated
11/27/2020
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