Healthcare Provider Details

I. General information

NPI: 1245239342
Provider Name (Legal Business Name): BEN H QUINNEY JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date: 03/20/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

1114 HOMER RD
MINDEN LA
71055-3028
US

IV. Provider business mailing address

1455 E BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT LA
71105-6000
US

V. Phone/Fax

Practice location:
  • Phone: 318-798-4616
  • Fax: 318-798-4619
Mailing address:
  • Phone: 318-798-4500
  • Fax: 318-798-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number011157
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: