Individual
SATHYA JAGANMOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8001 YOUREE DR STE 540, SHREVEPORT, LA 71115-2343
(318) 631-9121
(318) 631-9126
Mailing address
3217 MABEL ST, SHREVEPORT, LA 71103-4022
(318) 631-9121
(318) 631-9126
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
203683
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1059480
—
LA
01
—
MD.203683
STATE LICENSE
LA
Enumeration date
06/14/2007
Last updated
08/11/2022
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