Individual
JANE MARIE EGGERSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF SURGERY, CARDIOVASCULAR, SHREVEPORT, LA 71103-4228
(318) 813-2655
(318) 813-2673
Mailing address
1501 KINGS HWY, DEPARTMENT OF SURGERY, CARDIOVASCULAR, SHREVEPORT, LA 71103-4228
(318) 813-2655
(318) 813-2673
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
07090R
LA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
07090R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1359998
—
LA
Enumeration date
07/21/2006
Last updated
08/20/2009
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