Individual
ETHAN CALVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2161 AIRLINE DR STE B, BOSSIER CITY, LA 71111-3172
(318) 746-6288
(318) 746-7911
Mailing address
1509 DOCTORS DR, BOSSIER CITY, LA 71111-3321
(318) 746-6288
(318) 746-7911
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
100599
AR
247200000X
Other Technician
Primary
100599
LA
247200000X
Other Technician
100599
TX
Other
Enumeration date
11/24/2025
Last updated
01/16/2026
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