Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1980
NPI: 1538209697
Practice Locations (2)
2600 GREENWOOD RD
SHREVEPORT, LA 711033908
2751 ALBERT L BICKNELL DR, SUITE 5A
SHREVEPORT, LA 711033941
3182126688
Source: CMS National Downloadable File, September 2026.