Organization
LOUISIANA DERMATOLOGY SKIN CANCER CENTER A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN S WALSWORTH (OFFICE MANAGER)
(318) 387-6622
Entity
Organization
Contact information
Practice address
201 MCMILLAN RD, WEST MONROE, LA 71291-5321
(318) 387-6622
(318) 387-6030
Mailing address
201 MCMILLAN RD, WEST MONROE, LA 71291-5321
(318) 387-6622
(318) 387-6030
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
013630
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307360
—
LA
01
—
1396704904
DAVID WALSWORTH MD NPI #
LA
01
—
436889984A
BLUE CROSS
LA
Enumeration date
09/13/2006
Last updated
08/21/2014
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