Individual
DONALD LYNN SORRELLS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3133
(318) 212-5880
(318) 212-5885
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3133
(318) 212-5880
(318) 212-5885
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
021642
LA
2086S0120X
Pediatric Surgery Physician
Primary
MD.021642
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1495701
—
LA
Enumeration date
07/08/2005
Last updated
06/26/2013
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