Individual
RICHARD PRESTON MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF MEDICINE HEMATOLOGY, SHREVEPORT, LA 71103-4228
(318) 813-1057
(318) 813-1055
Mailing address
1501 KINGS HWY, DEPARTMENT OF MEDICINE HEMATOLOGY, SHREVEPORT, LA 71103-4228
(318) 813-1057
(318) 813-1055
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
013933
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1199966
—
LA
Enumeration date
07/21/2006
Last updated
06/19/2008
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