Organization
AMERIWEST HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH GREGORY STEPHENS M.D. (CHIEF EXECUTIVE OFFICER)
(318) 453-9707
Entity
Organization
Contact information
Practice address
727 EDGEMONT ST, SHREVEPORT, LA 71106-2223
(318) 453-9707
Mailing address
727 EDGEMONT ST, SHREVEPORT, LA 71106-2223
(318) 453-9707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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