Organization
HIGHLAND CLINIC, A PROF MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GUSTAVSON (ADMINISTRATOR)
(318) 798-4465
Entity
Organization
Contact information
Practice address
5025 SHED RD, BOSSIER CITY, LA 71111-5434
(318) 795-4741
(318) 795-4742
Mailing address
1455 E BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71105-5634
(318) 798-4500
(318) 798-4601
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
09/24/2020
Last updated
06/02/2026
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