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General NPI Number Information
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NPI Number | 1881889079
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Entity Type | Organization
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Legal Business Name | WINDER-TURK-JONES DERMATOLOGY APC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 742 PIERREMONT RD
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City | SHREVEPORT
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State | LA
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Zip | 71106-2212
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Country | US
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Telephone | 318-865-4631
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Fax | 318-865-0233
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Provider Business Mailing Address
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Address Line | 742 PIERREMONT RD
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City | SHREVEPORT
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State | LA
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Zip | 71106-2212
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Country | US
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Telephone | 318-865-4631
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Fax | 318-865-0233
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL R WINDER
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Credential | M.D.
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Telephone | 318-865-4631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 007868
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License Number State | LA
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