Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
LSUHSC-S Department of Pathology
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN BONSIB M.D. (MEDICAL DIRECTOR)
(318) 675-5700
Entity
Organization
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5700
Mailing address
PO BOX 53257, SHREVEPORT, LA 71135-3257
(318) 675-5700
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1791768
—
LA
Enumeration date
11/07/2006
Last updated
05/14/2009
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