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Individual

EZEKIEL ARTHUR LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2449 HOSPITAL DR, BOSSIER CITY, LA 71111-2399
(318) 841-4004
Mailing address
4531 CLINGMAN DR, SHREVEPORT, LA 71105-3211

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
338909
LA
363AM0700X
Medical Physician Assistant
Primary
338909
LA

Other

Enumeration date
09/21/2023
Last updated
06/09/2025
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