institution
Southern Pediatric Clinic
Health Service Clinic/Center in Shreveport, Louisiana
NPI 1104297720

Southern Pediatric Clinic is a Health Service Clinic/Center based in Shreveport, LA and is specialized in Health Service. Southern Pediatric Clinic practices in Shreveport, LA. The NPI Number for Southern Pediatric Clinic is 1104297720 and holds a License No. MD12866R (Louisiana).

The current practice location address for Southern Pediatric Clinic is 202 N Thomas Dr, Shreveport, LA and can be reached out via phone at 318-221-0277 and via fax at 318-221-3277. You can also correspond with Southern Pediatric Clinic through the mailing address at 202 N THOMAS DR, SHREVEPORT, LA - 71107-6539 (mailing address contact number: 318-221-0277).

Location: 202 N Thomas Dr, Shreveport, LA, 71107-6539
institution
Provider Profile Details
NPI Number
1104297720
Provider Name
Southern Pediatric Clinic
Credential
Provider Entity Type
Organization
Address
202 N Thomas Dr, Shreveport, LA, 71107-6539
Phone Number
318-221-0277
Fax Number
318-221-3277
Provider Enumeration Date
10/08/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1449237 05 LA
institution
Provider Business Practice Location Address Details
Address
202 N Thomas Dr
City
State
Zip
71107-6539
Phone Number
318-221-0277
Fax Number
318-221-3277
person
Provider Business Mailing Address Details
Address
202 N Thomas Dr
City
State
Zip
71107-6539
Phone Number
318-221-0277
Fax Number
318-221-3277
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
License No.
MD12866R (Louisiana)
Definition
Definition to come...
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