Individual
MILAN G MODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7925 YOUREE DR, SUITE 200, SHREVEPORT, LA 71105-5127
(318) 212-3610
(318) 212-3709
Mailing address
7925 YOUREE DR, SUITE 200, SHREVEPORT, LA 71105-5127
(318) 212-3610
(318) 212-3709
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
201245
LA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
201245
LA
207XS0117X
Orthopaedic Surgery of the Spine Physician
M1943
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457167
—
LA
Enumeration date
06/12/2006
Last updated
08/18/2008
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