Callegan-Poche', Amanda Lynn

Callegan-Poche', Amanda Lynn is an individual health care provider with primary practice located at 1023 Provenance Pl Ste 130 , Shreveport LA 71106-7796. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Callegan-Poche', Amanda Lynn can be contacted via phone (318) 626-0000.

Contact Information

Primary practice address
1023 Provenance Pl Ste 130 Shreveport LA 71106-7796
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 312618 Louisiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 312618 Louisiana

Profile Details

NPI number 1265829394
LBN Legal business name Callegan-Poche', Amanda Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2015
Last updated Sep 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265829394 NPPES
Louisiana MEDICAID 2388312

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