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Individual

DR. FEDERICO LAUREL AMPIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD.06280R
LA
2085R0202X
Diagnostic Radiology Physician
06280R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1338206
LA
Enumeration date
07/15/2006
Last updated
09/30/2024
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