Individual
AUSTIN W GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 LINE AVENUE, STE 200, SHREVEPORT, LA 71101
(318) 629-5555
(318) 629-5556
Mailing address
1500 LINE AVENUE, STE 204, SPORT, LA 71101
(318) 629-5001
(318) 629-5020
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
010006
LA
207X00000X
Orthopaedic Surgery Physician
Primary
10006
LA
Other
Enumeration date
08/18/2005
Last updated
01/30/2008
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