Carr, Russell Shane

Carr, Russell Shane is an individual health care provider with primary practice located at 1811 E Bert Kouns Industrial Loop Suite 400, Shreveport LA 71105-5740. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Carr, Russell Shane can be contacted via phone (318) 212-3810.

Contact Information

Primary practice address
1811 E Bert Kouns Industrial Loop Suite 400 Shreveport LA 71105-5740
Phone: (318) 212-3810
Fax: (318) 212-3815
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12951R Louisiana

Profile Details

NPI number 1245205335
LBN Legal business name Carr, Russell Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Jun 21st, 2021 - about 4 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 1245205335 NPPES
Louisiana MEDICAID 1556581

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