Individual
KELLY REED LODGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3326 FRONT ST STE B, WINNSBORO, LA 71295
(318) 435-7333
(318) 435-9061
Mailing address
3326 FRONT ST STE B, WINNSBORO, LA 71295-6418
(318) 435-7333
(318) 435-9061
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
303772
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2390899
—
LA
Enumeration date
05/14/2015
Last updated
07/17/2018
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