Individual
JAMES LUSK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
451 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7229
(318) 222-5555
(318) 222-6414
Mailing address
451 ASHLEY RIDGE BLVD, SHREVEPORT, LA 71106-7229
(318) 222-5555
(318) 222-6414
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L04501R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10411
LA CONTROLLED SUB#
LA
05
—
1301116
—
LA
01
—
L04501R
LA MEDICAL LIC. #
LA
Enumeration date
03/08/2006
Last updated
03/07/2023
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