Individual
ASHLEY N FORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF FAMILY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1501 KINGS HWY, DEPARTMENT OF FAMILY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 200178
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1065676
—
LA
Enumeration date
05/13/2008
Last updated
01/22/2015
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