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1194761163

NPI Code Detail

MEDICARE: DR. PAMELA MCPHERSON MD

MEDICARE: DR. PAMELA MCPHERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084F0202X	Forensic Psychiatry Physician	18968	LA
2	2084P0804X	Child & Adolescent Psychiatry Physician	18968	LA
3	2084P0800X	Psychiatry Physician	18968	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194761163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA MCPHERSON MD

Provider Business Mailing Address
First Line	:	833 THORA BLVD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-1519
Country	:	US
Telephone Number	:	318-868-4331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 N HEARNE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71107-6516
Country	:	US
Telephone Number	:	318-676-5111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	11/13/2025

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Directions to “ DR. PAMELA MCPHERSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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