Individual
DR. JAMES WILLIAM SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1512 W KIRBY PL, DEPARTMENT OF EMERGENCY MEDICINE, SHREVEPORT, LA 71103-3822
(318) 675-7636
(318) 675-7531
Mailing address
1501 KINGS HWY, DEPARTMENT OF EMERGENCY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-6880
(318) 675-6895
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
016878
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1333409
—
LA
01
—
54088F600
MEDICARE - PTAN
LA
Enumeration date
07/19/2006
Last updated
06/16/2011
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