Individual
MCLEOD GWYNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
346503
LA
2084P0800X
Psychiatry Physician
TL29219
SC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
346503
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292196
—
SC
Enumeration date
10/05/2006
Last updated
07/23/2025
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