Individual
JOHN D DANZELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 KINGS HIGHWAY, SHREVEPORT, LA 71103
(318) 631-4030
(318) 631-4031
Mailing address
2500 KINGS HIGHWAY, SHREVEPORT, LA 71103
(318) 631-4030
(318) 631-4031
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
013603
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307891
—
LA
Enumeration date
10/25/2006
Last updated
04/03/2024
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