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Individual

DR. KURT THOMAS GROZINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2105 AIRLINE DR, BOSSIER CITY, LA 71111-3105
(318) 741-6078
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
05413R
LA
2085R0202X
Diagnostic Radiology Physician
05413R
LA
2085R0202X
Diagnostic Radiology Physician
Primary
MD.05413R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05413R
MEDICAL LICENSE
LA
Enumeration date
06/09/2005
Last updated
04/12/2022
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