Individual
RANDALL I DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 SAINT MARY PL, SHREVEPORT, LA 71101-4343
(318) 773-5880
Mailing address
10745 LONGFELLOW TRCE, SHREVEPORT, LA 71106-9340
(318) 332-8297
(318) 779-1907
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
023624
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1486647
—
LA
Enumeration date
01/26/2006
Last updated
07/22/2013
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