Individual
DR. RANDALL C CORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5581
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5581
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
09580R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021774
CDS
—
05
—
1978833
—
LA
Enumeration date
10/17/2006
Last updated
03/07/2023
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