Individual
DR. RAGHAVARAO ALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
06102R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1335096
—
LA
Enumeration date
06/15/2005
Last updated
10/13/2023
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