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General NPI Number Information
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NPI Number | 1346201829
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Entity Type | Individual
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Provider Name | LOUIS R RENSHAW JR. PA
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Gender | Male
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Dates
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Enumeration Date | 04/01/2006
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 8303 BLANTON STREET
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City | SPRING HILL
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State | FL
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Zip | 34606
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Country | US
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Telephone | 352-686-3154
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Fax | 352-688-2751
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Provider Business Mailing Address
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Address Line | 8303 BLANTON STREET
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City | SPRING HILL
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State | FL
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Zip | 34606
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Country | US
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Telephone | 352-686-3154
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Fax | 352-688-2751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1667
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License Number State | FL
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