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Individual

DR. ERNEST L KISTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 SAINT MARY PL, ANESTHESIA DEPT, SHREVEPORT, LA 71101-4343
(866) 214-8600
(888) 411-4191
Mailing address
PO BOX 9600, DEPT 09-039, TEXARKANA, TX 75505-9600
(866) 214-8600
(888) 411-4191

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
014584
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050016353
MEDICARE RAILROAD
LA
05
1344877
LA
Enumeration date
11/10/2005
Last updated
02/09/2015
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