Individual
DR. EDWIDG EUGENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
2001 DOCTORS DR, SPRINGHILL, LA 71075-4526
(318) 539-1041
(318) 539-4097
Mailing address
5619 MIRADOR CIR, SHREVEPORT, LA 71119-4009
(318) 539-1041
(318) 635-7224
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
05402R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316211
—
LA
Enumeration date
08/03/2006
Last updated
01/27/2009
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