Healthcare Provider Details

I. General information

NPI: 1700819752
Provider Name (Legal Business Name): CENTER FOR HAND SURGERY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 BERT KOUNS INDUSTRIAL LOOP SUITE 500
SHREVEPORT LA
71106-8158
US

IV. Provider business mailing address

PO BOX 6640
SHREVEPORT LA
71136-6640
US

V. Phone/Fax

Practice location:
  • Phone: 318-686-9986
  • Fax: 318-686-9505
Mailing address:
  • Phone: 318-686-9986
  • Fax: 318-686-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number10060R
License Number StateLA

VIII. Authorized Official

Name: MICHELLE R RITTER
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 318-686-9986