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Southern Pediatric Clinic
Primary Care Clinic/Center in Shreveport, Louisiana
NPI 1528432440

Southern Pediatric Clinic is a Primary Care Clinic/Center based in Shreveport, LA and is specialized in Primary Care. Southern Pediatric Clinic practices in Shreveport, LA. The NPI Number for Southern Pediatric Clinic is 1528432440 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.

Location: 202 N Thomas Dr, Shreveport, LA, 71107-6539
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1528432440
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
Provider Enumeration Date
11/16/2015
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
Shreveport
State
Louisiana
Zip
71107-6539
Phone Number
318-221-0277
Fax Number
person
Provider Business Mailing Address Details
Address
202 N Thomas Dr
City
Shreveport
State
Louisiana
Zip
71107-6539
Phone Number
318-221-0277
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
MD12866R (Louisiana)
Definition
Definition to come...
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