Organization
LOUISIANA NEUROLOGIC SPECIALTIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN BANG V. NGUYEN M.D. (OWNER)
(318) 424-3268
Entity
Organization
Contact information
Practice address
7929 YOUREE DR, SHREVEPORT, LA 71105-5538
(318) 424-3268
(318) 424-3280
Mailing address
7929 YOUREE DR, SHREVEPORT, LA 71105-5538
(318) 424-3268
(318) 424-3280
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
09699R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1981087
—
LA
Enumeration date
02/12/2007
Last updated
08/24/2007
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