Organization
DERMATOLOGY & SKIN CANCER SPECIALISTS, LLC
Active
Parent organization
DERMATOLOGY & SKIN CANCER SPECIALISTS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DERMATOLOGY & SKIN CANCER SPECIALISTS, LLC
Authorized official
CAROL R WADSWORTH (OFFICE MANAGER)
(318) 686-2021
Entity
Organization
Contact information
Practice address
9314 NORMANDIE DR, SHREVEPORT, LA 71118-3866
(318) 686-2021
(318) 688-6329
Mailing address
PO BOX 17607, SHREVEPORT, LA 71138-0607
(318) 686-2021
(318) 688-6329
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD02411R
LA
Other
Enumeration date
01/17/2007
Last updated
06/05/2013
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