Organization
SHREVEPORT ANESTHESIA PROVIDERS LLC
Active
Organization
SHREVEPORT ANESTHESIA PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL R NOBACK MD (MEDICAL DIRECTOR)
(888) 337-3509
Entity
Organization
Contact information
Practice address
385 BERT KOUNS INDUSTRIAL LOOP, BLDG 300, SHREVEPORT, LA 71106-8158
(318) 212-0552
Mailing address
PO BOX 865210, ORLANDO, FL 32886-0001
(888) 337-3509
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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