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General NPI Number Information
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NPI Number | 1730367798
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Entity Type | Organization
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Legal Business Name | DRS. EDDLEMAN AND GLADNEY, AMP
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 1801 FAIRFIELD AVE SUITE 306
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City | SHREVEPORT
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State | LA
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Zip | 71101-4443
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Country | US
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Telephone | 318-222-9419
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 FAIRFIELD AVE SUITE 306
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City | SHREVEPORT
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State | LA
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Zip | 71101-4443
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Country | US
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Telephone | 318-222-9419
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Fax |
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Authorized Official
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Title or Position | PARTNER/MEMBER
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Name | JOHN D. GLADNEY
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Credential | M.D.
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Telephone | 318-222-9419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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