Organization
JANI KAMLESH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANI KAMLESH MD (PRESIDENT)
(318) 773-0657
Entity
Organization
Contact information
Practice address
9320 LINWOOD AVE, SHREVEPORT, LA 71106-7003
(318) 773-0657
(318) 688-0326
Mailing address
PO BOX 19284, SHREVEPORT, LA 71149-0284
(318) 773-0657
(318) 688-0326
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11929R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061823115
BLUE CROSS
LA
Enumeration date
01/16/2009
Last updated
01/16/2009
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