Individual
DR. WILLIAM REID GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1811 E BERT KOUNS STE 430, SHREVEPORT, LA 71105
(318) 424-8373
(318) 424-6477
Mailing address
1811 E BERT KOUNS STE 430, SHREVEPORT, LA 71105-5741
(318) 424-8373
(318) 424-6477
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
015952
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106411502
—
TX
05
—
1397202
—
LA
Enumeration date
06/14/2006
Last updated
08/27/2018
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