Individual
KIRTAN NALIN KOTICHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1455 E BERT KOUN LOOP # 101, SHREVEPORT, LA 71105-5634
(318) 798-4424
(318) 798-4450
Mailing address
1455 E. BERT KOUNS, SHREVEPORT, LA 71105
(318) 798-4424
(318) 798-4450
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
204824
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1099881
—
LA
Enumeration date
05/25/2007
Last updated
10/08/2018
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