Individual
KENNETH DOMINIC ABREO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0287
(318) 629-4833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.06699R
LA
207RN0300X
Nephrology Physician
Primary
06699R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1351334
—
LA
Enumeration date
07/24/2006
Last updated
03/11/2024
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