Individual
EDWARD J. MILLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF OTOLARYNGOLOGY, SHREVEPORT, LA 71103-4228
(318) 813-2690
(318) 813-2692
Mailing address
1501 KINGS HWY, DEPARTMENT OF OTOLARYNGOLOGY, SHREVEPORT, LA 71103-4228
(318) 813-2690
(318) 813-2692
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
017310
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1354490
—
LA
01
—
50658F600
MEDICARE - PTAN
LA
Enumeration date
07/12/2006
Last updated
08/22/2011
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