Organization
HEALING GRACE INTERNAL MEDICINE & PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA CLAYTON M.D. (PRESIDENT)
(318) 671-9309
Entity
Organization
Contact information
Practice address
6821 PINES RD, SUITE 200, SHREVEPORT, LA 71129-2547
(318) 671-9309
(318) 671-9311
Mailing address
6821 PINES RD, SUITE 200, SHREVEPORT, LA 71129-2547
(318) 671-9309
(318) 671-9311
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
023335
LA
207R00000X
Internal Medicine Physician
Primary
023335
LA
208000000X
Pediatrics Physician
023335
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1494046
—
LA
Enumeration date
04/24/2007
Last updated
09/11/2025
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