Individual
EDWARD HOPKINS LEATHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY, SHREVEPORT, LA 71103-4228
(318) 675-7737
(318) 675-5666
Mailing address
1501 KINGS HWY, DEPARTMENT OF PSYCHIATRY, SHREVEPORT, LA 71103-4228
(318) 675-7737
(318) 675-5666
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
009829
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1121207
—
LA
Enumeration date
07/09/2006
Last updated
07/08/2007
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