Individual
SHIVA DOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1501 KINGS HWY, EMERGENCY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-7205
(318) 675-6878
Mailing address
1501 KINGS HWY, EMERGENCY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-7205
(318) 675-6878
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA200026
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1151726
—
LA
Enumeration date
06/23/2006
Last updated
09/10/2014
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