Individual
DR. JODY DALE CHANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2125 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105-5314
(318) 401-1766
Mailing address
2125 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105-5314
(318) 401-1766
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
201154
LA
207P00000X
Emergency Medicine Physician
V7353
TX
207Q00000X
Family Medicine Physician
201154
LA
207Q00000X
Family Medicine Physician
Primary
V7353
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1038130
—
LA
01
—
MD.201154
LICENSE
LA
Enumeration date
10/26/2006
Last updated
08/08/2025
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