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NPI Code Detail

MEDICARE: DR. JESSE LEE HITE M.D.

MEDICARE: DR. JESSE LEE HITE 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
12084P0800XPsychiatry Physician08645RLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245253681
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSE LEE HITE M.D.
Provider Business Mailing Address
First Line : 318 WILDOAK DR
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-8228
Country : US
Telephone Number : 318-798-1722
Fax Number : 318-797-2258
Provider Business Practice Location Address
First Line : 1310 N HEARNE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-6516
Country : US
Telephone Number : 318-676-5111
Fax Number : 318-676-5137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/08/2007

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