Organization
ANESTHESIA SERVICES OF SHREVEPORT-BOSSIER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WINSTON E MOORE JR. MD (PRESIDENT)
(318) 797-1743
Entity
Organization
Contact information
Practice address
1945 E 70TH ST, SUITE B, SHREVEPORT, LA 71105-5347
(318) 797-1743
(318) 797-7599
Mailing address
PO BOX 52448, SHREVEPORT, LA 71135-2448
(318) 797-1743
(318) 797-7599
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
015590
LA
Other
Enumeration date
05/23/2007
Last updated
11/17/2011
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