MEDICARE: DR. SELCUK SOZEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	04129R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AL4828	OTHER	LA	COMMUNITY HEALTH

General Provider Information

NPI Number	:	1063572451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SELCUK SOZEN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12237
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71315-2237
Country	:	US
Telephone Number	:	318-473-9003
Fax Number	:	318-473-0437

Provider Business Practice Location Address
First Line	:	211 4TH ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8421
Country	:	US
Telephone Number	:	318-769-4500
Fax Number	:	318-473-0437

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	02/22/2026

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