Individual
DR. DREW RICHARD DETHLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-6111
(318) 675-6138
Mailing address
PO BOX 33932, SHREVEPORT, LA 71130-3932
(318) 675-6111
(318) 675-6138
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
351978
LA
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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