Organization
SHREVEPORT INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD E. HAYNIE M.D. (PRESIDENT)
(318) 621-2929
Entity
Organization
Contact information
Practice address
1449 E BERT KOUNS INDUSTRIAL LOOP, SUITE 100, SHREVEPORT, LA 71105-5634
(318) 629-0220
Mailing address
1449 E BERT KOUNS INDUSTRIAL LOOP, SUITE 100, SHREVEPORT, LA 71105-5634
(318) 629-0220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
LA
Other
Enumeration date
05/17/2006
Last updated
07/21/2022
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