Individual
SUSAN DIANA VEILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PATHOLOGY, SHREVEPORT, LA 71103-4228
(315) 675-5000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
018674
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1918971
—
LA
01
—
4R011F600
MEDICARE - PTAN
LA
Enumeration date
07/10/2006
Last updated
05/08/2014
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