Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation in Shreveport - Foot & Ankle Surgery
Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation - NPI 1033111240
Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation is a Foot & Ankle Surgery in Shreveport, Louisiana. Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation practices all healthcare services and medical treatments related to Foot & Ankle Surgery. The NPI Number for Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation is 1033111240. The last update date is 2023-06-08.
Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation's current location address is 9308 Mansfield Rd, Shreveport, Louisiana. You can contact this provider via phone number 3186876266 and fax number 3186831023. The mailing address for Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation is 9308 Mansfield Rd, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation |
|---|---|
| Address | 9308 Mansfield Rd, Shreveport, Louisiana |
| Phone Number | 3186876266 |
| Fax Number | 3186831023 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN/ |
|---|---|
| Authorized Official Name | Havens Taylor Richard |
| Credentials | D.P.M. |
| Telephone Number | 3186876266 |
NPI Number Detail
| NPI Number | 1033111240 |
|---|---|
| Provider Enumeration Date | 2005-06-01 |
| Last Updated Date | 2023-06-08 |
Provider Mailing Address Detail
| Address | 9308 Mansfield Rd |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 7111831340 |
| Phone Number | 3186876266 |
| Fax Number | 3186831023 |
Provider's Primary Taxonomy Detail
| Speciality | Foot & Ankle Surgery |
|---|---|
| Taxonomy | 213Es0103X |
| Licence No | 5B496 |
|
Definition: A doctor of podiatric medicine who diagnoses and treats disorders and injuries to the foot, ankle and related structures. |
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What is the unique identification code assigned to Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation by the Centers for Medicare & Medicaid Services?
The Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation has been issued the NPI (National Provider Identifier) 1033111240. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation is physically located?
The Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation is physically situated at the following address: 9308 Mansfield Rd, Shreveport, LA, 7111831340.
What is Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation is Foot & Ankle Surgery, and the taxonomy classification code that categorizes this area of expertise is 213Es0103X.
On what date did the Centers for Medicare & Medicaid Services assign the 1033111240 to Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation?
The Centers for Medicare & Medicaid Services assigned the 1033111240 to Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation on 2005-06-01.
When was the information regarding Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Southside Foot Clinic Of Shreveport, Inc. A Professional Corporation, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2023-06-08.