Organization
MEDCONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI BEAVERS (CREDENTIALING MANAGER)
(318) 325-6200
Entity
Organization
Contact information
Practice address
2533 BERT KOUNS INDUSTRIAL LOOP, SUITE 104, SHREVEPORT, LA 71118-3158
(318) 698-8889
(318) 698-8893
Mailing address
2533 BERT KOUNS INDUSTRIAL LOOP, SUITE 104, SHREVEPORT, LA 71118-3158
(318) 698-8889
(318) 698-8893
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
08006R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720013261
INDIVIDUAL NPI
LA
Enumeration date
05/26/2016
Last updated
10/04/2016
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