Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
LSUHSC Nephrology Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELANIE SOTAK MHSA (DIRECTOR OF MANAGED CARE)
(318) 675-7737
Entity
Organization
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF INTERNAL MEDICINE - SECTION OF NEPHROLOGY, SHREVEPORT, LA 71103-4228
(318) 424-4008
(318) 424-6606
Mailing address
1501 KINGS HWY, DEPARTMENT OF INTERNAL MEDICINE - NEPHROLOGY SECTION, SHREVEPORT, LA 71103-4228
(318) 675-7402
(318) 675-5913
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
142
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1444715
—
LA
Enumeration date
05/28/2008
Last updated
05/28/2008
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