SOUTHSIDE FOOT CLINIC OF SHREVEPORT, INC. A PROFESSIONAL CORPORATION is a foot and ankle surgery podiatrist in Shreveport, LA. SOUTHSIDE FOOT CLINIC OF SHREVEPORT, INC. A PROFESSIONAL CORPORATION NPI is 1033111240. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southside Foot Clinic.
The provider's business location address is:
9308 MANSFIELD RD
STE 100
SHREVEPORT, LA
ZIP 71118-134
Phone: (318) 687-6266
Fax: (318) 683-1023
The provider's authorized official is Richard Taylor Havens .
The authorized official title is Physician/administrator and has the following contact phone number (318) 687-6266.
The enumeration date for this NPI number is 6/1/2005 and was last updated on 6/8/2023.