Individual
DR. STEPHEN ROYCE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ONE SAINT MARY PLACE, SHREVEPORT, LA 71101-0000
(318) 681-6812
(318) 684-7185
Mailing address
ONE SAINT MARY PLACE, SHREVEPORT, LA 71101-0000
(318) 681-6812
(318) 684-7185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.202386
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1358193
—
LA
05
—
175409001
—
AR
05
—
203329201
—
TX
Enumeration date
07/24/2007
Last updated
03/08/2012
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