Individual
CLARENCE RAPHIEL TEAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8001 YOUREE DR, SUITE 450, SHREVEPORT, LA 71115-2302
(318) 212-3952
(318) 212-3955
Mailing address
8001 YOUREE DR, SUITE 450, SHREVEPORT, LA 71115-2302
(318) 212-3952
(318) 212-3955
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
009465
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1097144
—
LA
Enumeration date
07/05/2006
Last updated
12/05/2007
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