Carson Shetley Holtzclaw in Shreveport - Physician Assistant
Carson Shetley Holtzclaw - NPI 1033390398
Carson Shetley Holtzclaw is a Physician Assistant in Shreveport, Louisiana. Carson Shetley Holtzclaw practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Carson Shetley Holtzclaw is 1033390398. The last update date is 2022-07-21.
Carson Shetley Holtzclaw's current location address is 6841 Fern Ave Ste 100, Shreveport, Louisiana. You can contact this provider via phone number 3188682273 and fax number 3188684219. The mailing address for Carson Shetley Holtzclaw is 6841 Fern Ave Ste 100, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carson Shetley Holtzclaw |
|---|---|
| Address | 6841 Fern Ave Ste 100, Shreveport, Louisiana |
| Phone Number | 3188682273 |
| Fax Number | 3188684219 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1033390398 |
|---|---|
| Provider Enumeration Date | 2007-11-15 |
| Last Updated Date | 2022-07-21 |
Provider Mailing Address Detail
| Address | 6841 Fern Ave Ste 100 |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 711054175 |
| Phone Number | 3188682273 |
| Fax Number | 3188684219 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA200181 |
|
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1157872 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Carson Shetley Holtzclaw by the Centers for Medicare & Medicaid Services?
The Carson Shetley Holtzclaw has been assigned the NPI (National Provider Identifier) 1033390398 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Carson Shetley Holtzclaw?
The Carson Shetley Holtzclaw is situated at 6841 Fern Ave Ste 100, in the city of Shreveport, state of LA, with the zip code 711054175.
What is Carson Shetley Holtzclaw's area of expertise and its corresponding taxonomy classification?
The Carson Shetley Holtzclaw's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Carson Shetley Holtzclaw receive the assignment of its 1033390398 from the Centers for Medicare & Medicaid Services?
The Carson Shetley Holtzclaw was issued its 1033390398 by the Centers for Medicare & Medicaid Services on 2007-11-15.
As of what date were the Carson Shetley Holtzclaw's details last updated?
The information pertaining to the Carson Shetley Holtzclaw, including its address, specialty, and other details, was most recently updated on 2022-07-21.
NPI Number: 1053314252
Address: 10220 Prairie Ridge Blvd, Pleasant Prairie, WI
NPI Number: 1720081912
Address: 111 Edgartown Rd, Vineyard Haven, MA