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Individual

DR. PHILIP EDWIN GATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3100 SAMFORD AVE, SHREVEPORT, LA 71103-4239
(318) 226-3306
(318) 226-3319
Mailing address
PO BOX 8500, LOCKBOX 7642, PHILADELPHIA, PA 19178-7642
(813) 281-8478
(813) 281-8113

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10329R
LA
207X00000X
Orthopaedic Surgery Physician
E8504
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1698857
LA
Enumeration date
01/26/2006
Last updated
11/13/2012
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