Individual
KELLY E WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1453 E BERT KOUNS INDUSTRIAL LOOP, RADIOLOGY, SHREVEPORT, LA 71105-6800
(318) 681-4347
Mailing address
PO BOX 9600, DEPT 09-038, TEXARKANA, TX 75505-9600
(877) 243-8416
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD020531
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1672050
—
LA
Enumeration date
06/05/2006
Last updated
04/02/2025
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