Individual
JENNIFER PRIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2551 GREENWOOD RD, SUITE 410, SHREVEPORT, LA 71103-3981
(318) 621-2929
(318) 621-2930
Mailing address
2551 GREENWOOD RD, SUITE 410, SHREVEPORT, LA 71103-3981
(318) 621-2929
(318) 621-2930
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD203889
LA
Other
Enumeration date
04/14/2009
Last updated
11/30/2015
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