Organization
CHERISE A IRBY, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERISE A IRBY M.D. (OWNER)
(318) 629-4729
Entity
Organization
Contact information
Practice address
1801 FAIRFIELD AVE, SUITE 103, SHREVEPORT, LA 71101-4443
(318) 629-4729
(318) 629-4730
Mailing address
1801 FAIRFIELD AVE, SUITE 103, SHREVEPORT, LA 71101-4443
(318) 629-4729
(318) 629-4730
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
024995
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0402562
UNITED HEALTHCARE
LA
05
—
1423301
—
LA
01
—
273431
COVENTRY
LA
01
—
7483495
AETNA
LA
01
—
P00023608
RAILROAD MEDICARE
LA
Enumeration date
11/13/2007
Last updated
11/13/2007
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