Individual
KAROLYNE MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
330190
LA
Other
Enumeration date
05/28/2021
Last updated
03/01/2023
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