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Individual

JEFFREY M GOSSLEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 N ASHLEY RIDGE LOOP STE 400, SHREVEPORT, LA 71106-7233
(318) 841-8844
(318) 841-8845
Mailing address
PO BOX 65265, SHREVEPORT, LA 71136-5265
(318) 841-8844
(318) 841-8845

Taxonomy

Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
M3563
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
MD026087
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053201
LA
01
1356320568
IND NPI
LA
01
1568851053
GROUP NPI
LA
Enumeration date
01/16/2006
Last updated
10/30/2023
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