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Individual

DARRELL L FOUTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
8001 YOUREE DR, SHREVEPORT, LA 71115-2302
(318) 212-3220
Mailing address
10014 ROCKY KNOLL CIR, SHREVEPORT, LA 71106-7650
(318) 797-3135

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN057165AP01505
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1904589
LA
Enumeration date
10/27/2005
Last updated
09/19/2008
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