Individual
SANJEEVI C. TIVAKARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 HOSPITAL DR, SUITE 220, BOSSIER CITY, LA 71111-2385
(318) 752-7840
(318) 752-7845
Mailing address
2400 HOSPITAL DR, SUITE 220, BOSSIER CITY, LA 71111-2385
(318) 752-7840
(318) 752-7845
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
11838R
LA
Other
Enumeration date
03/08/2007
Last updated
10/03/2007
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