Individual
CODY TINGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7591 FERN AVE STE 1401, SHREVEPORT, LA 71105-5747
(318) 828-2827
(318) 203-5145
Mailing address
7591 FERN AVE STE 1401, SHREVEPORT, LA 71105-5747
(318) 828-2827
(318) 203-5145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.2078919
LA
207R00000X
Internal Medicine Physician
Primary
MD.207919
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2189328
—
LA
Enumeration date
04/09/2012
Last updated
03/09/2026
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