Individual
MACKEY SUGAR QUINLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PEDIATRICS, SHREVEPORT, LA 71103-4228
(318) 212-3900
Mailing address
1501 KINGS HWY, DEPARTMENT OF PEDIATRICS, SHREVEPORT, LA 71103-4228
(318) 212-3900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD202876
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00170
—
LA
Enumeration date
05/25/2007
Last updated
10/25/2017
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