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Individual

PHILIP DONALD ISHERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5185
(318) 675-7950
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5185
(318) 675-7950

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13714R
LA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
13714R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1423131
LA
Enumeration date
06/23/2006
Last updated
04/24/2025
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