Individual
DR. KELLY MORGAN CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
ONE SAINT MARY PLACE, SHREVEPORT, LA 71101-0000
(318) 681-6812
(318) 681-7185
Mailing address
ONE SAINT MARY PLACE, SHREVEPORT, LA 71101-0000
(318) 681-6812
(318) 684-7185
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14004R
LA
207R00000X
Internal Medicine Physician
Primary
MD.14004R
LA
207R00000X
Internal Medicine Physician
MD60821843
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1183661
—
LA
Enumeration date
01/17/2006
Last updated
10/23/2023
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