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Kenneth Mekelburg Md
Specialist in Bossier City, Louisiana
NPI 1245490945

Kenneth Mekelburg Md is a Specialist based in Shreveport, LA. Kenneth Mekelburg Md practices in Bossier City, LA. The NPI Number for Kenneth Mekelburg Md is 1245490945 and holds a License No. 13801R (Louisiana).

The current practice location address for Kenneth Mekelburg Md is 2525 Viking Drive, Bossier City, LA and can be reached out via phone at 318-425-4096 and via fax at 318-681-6812.

Location: 2525 Viking Drive, Bossier City, LA, 71165-1684
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1245490945
Provider Name
Kenneth Mekelburg Md
Credential
Provider Entity Type
Organization
Address
2525 Viking Drive, Bossier City, LA, 71165-1684
Phone Number
318-425-4096
Fax Number
318-681-6812
Provider Enumeration Date
06/16/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1436836 05 LA
institution
Provider Business Practice Location Address Details
Address
2525 Viking Drive
City
Bossier City
State
Louisiana
Zip
71111-2103
Phone Number
318-425-4096
Fax Number
318-681-6812
person
Provider Business Mailing Address Details
Address
2525 Viking Drive
City
Bossier City
State
Louisiana
Zip
71111-2103
Phone Number
318-425-4096
Fax Number
318-681-6812
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
13801R (Louisiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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