Individual
KEITH ALEXIUS WANGKAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-8695
Mailing address
1846 FAIRFIELD AVE APT 1114, SHREVEPORT, LA 71101-4454
(318) 207-5245
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
347888
LA
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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