Individual
DR. ANSHUMAN JYOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 203, SHREVEPORT, LA 71118-3175
(318) 212-5871
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP STE 203, SHREVEPORT, LA 71118-3175
(318) 212-5871
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
204139
LA
2084P0804X
Child & Adolescent Psychiatry Physician
204139
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07925
—
LA
Enumeration date
05/30/2007
Last updated
07/05/2012
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