Individual
PAVAN KATIKANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1453 E BERT KOUN LOOP STE 112, SHREVEPORT, LA 71105-6810
(318) 798-9400
(318) 795-4656
Mailing address
PO BOX 51008, SHREVEPORT, LA 71135-1008
(318) 798-9400
(318) 795-4656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.204680
LA
207RC0000X
Cardiovascular Disease Physician
MD.204680
LA
207RI0011X
Interventional Cardiology Physician
Primary
MD.204680
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05962
—
LA
Enumeration date
05/15/2008
Last updated
01/23/2024
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