Individual
DR. SUSAN MARIE SHATTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8001 YOUREE DR, SUITE 350, SHREVEPORT, LA 71115-2302
(318) 524-0114
(318) 524-0195
Mailing address
8001 YOUREE DR STE 350, SHREVEPORT, LA 71115-2330
(318) 524-0114
(318) 524-0195
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
013942
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1311421
—
LA
Enumeration date
06/28/2005
Last updated
05/18/2011
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