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Individual

PATRICK LEROY MCGAULY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-6885
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-6885

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
023155
LA
207R00000X
Internal Medicine Physician
23155
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1492019
LA
Enumeration date
10/02/2006
Last updated
01/24/2014
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