MEDICARE: DR. KIMBERLY DAWN LAW M.D., M.P.H.

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	2084P0800X	Psychiatry Physician	MD.199987	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

General Provider Information

NPI Number	:	1427029438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY DAWN LAW M.D., M.P.H.

Provider Business Mailing Address
First Line	:	2920 KNIGHT ST
Second Line	:	SUITE 110
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2412
Country	:	US
Telephone Number	:	318-861-7340
Fax Number	:	318-861-7390

Provider Business Practice Location Address
First Line	:	2920 KNIGHT ST
Second Line	:	SUITE 110
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2412
Country	:	US
Telephone Number	:	318-861-7340
Fax Number	:	318-861-7390

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

Provider Enumeration Date	:	01/28/2006
Last Update Date	:	11/09/2010

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