Individual
DR. KERRY W TYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1455 E BERT KOUNS INDUSTRIAL LOOP STE 306, SHREVEPORT, LA 71105-5634
(318) 798-4400
(318) 798-4531
Mailing address
1455 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105-6000
(318) 798-4500
(318) 798-4601
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
025696
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041882
—
LA
01
—
1053315846
GROUP NPI NUMBER
LA
01
—
177481202
TEXAS MEDICAID NUMBER
TX
01
—
P00282489
RAILROAD MEDICARE
LA
Enumeration date
08/25/2005
Last updated
02/02/2026
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