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General NPI Number Information
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NPI Number | 1487009833
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Entity Type | Organization
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Legal Business Name | LAUREN A LUSK MD LLC
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 1002 HIGHLAND AVE SUITE 300
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City | SHREVEPORT
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State | LA
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Zip | 71101-4143
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Country | US
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Telephone | 318-678-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 HIGHLAND AVE SUITE 300
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City | SHREVEPORT
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State | LA
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Zip | 71101-4143
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Country | US
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Telephone | 318-364-9083
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LAUREN AUSTIN LUSK
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Credential | M.D.
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Telephone | 318-364-9083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD.205850
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License Number State | LA
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