Organization
COMPREHENSIVE NEUROSURGERY NETWORK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVISH V PATWARDHAN M.D. (OWNER)
(318) 797-5543
Entity
Organization
Contact information
Practice address
8001 YOUREE DR, SUITE 970, SHREVEPORT, LA 71115-2302
(318) 797-5543
Mailing address
PO BOX 1768, SHREVEPORT, LA 71166-1768
(318) 222-8367
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
14643R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053937
—
LA
Enumeration date
05/23/2006
Last updated
03/31/2008
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