Organization
WEBB INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN A WEBB MD (OWNER)
(318) 220-7047
Entity
Organization
Contact information
Practice address
1811 E BERT KOUNS INDUSTRIAL LOOP, SUITE 480, SHREVEPORT, LA 71105-5740
(318) 220-7047
Mailing address
1811 E BERT KOUNS INDUSTRIAL LOOP, SUITE 480, SHREVEPORT, LA 71105-5740
(318) 220-7047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
721669340
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1540030
—
LA
Enumeration date
06/09/2006
Last updated
12/26/2012
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