Individual
JATINDER BHARDWAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
300245
LA
208000000X
Pediatrics Physician
C161299
CA
208000000X
Pediatrics Physician
IN PROCESS
NY
2080P0206X
Pediatric Gastroenterology Physician
Primary
300245
LA
2080P0206X
Pediatric Gastroenterology Physician
35097380
OH
2080P0206X
Pediatric Gastroenterology Physician
C161299
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000733570
ANTHEM
OH
05
—
0054928
—
OH
05
—
2433369
—
LA
01
—
75264
MERIDAN
OH
01
—
9353771
AETNA
OH
Enumeration date
12/14/2006
Last updated
03/22/2024
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