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General NPI Number Information
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NPI Number | 1790705010
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Entity Type | Individual
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Provider Name | CURTIS A. PREJEAN JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 2751 ALBERT L. BICKNELL DR. SUITE 5C
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City | SHREVEPORT
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State | LA
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Zip | 71103-3920
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Country | US
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Telephone | 318-227-9777
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Fax | 318-459-1188
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Provider Business Mailing Address
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Address Line | 2751 ALBERT L. BICKNELL DR. SUITE 5C
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City | SHREVEPORT
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State | LA
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Zip | 71103-3920
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Country | US
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Telephone | 318-227-9777
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Fax | 318-459-1188
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | A44098
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 015075
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License Number State | LA
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