Organization
UNIVERSITY HEALTH SHREVEPORT LLC
Active
Other names
Ochsner LSU Health Shreveport
Organization subpart
No
Provider details
NPI number
Authorized official
VERNON MOORE III (CFO)
(318) 626-0000
Entity
Organization
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-7636
(318) 675-7531
Mailing address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-7636
(318) 675-7531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
12/10/2018
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