Gundaji, Jagadeeshwar

Gundaji, Jagadeeshwar is an individual health care provider with primary practice located at 1501 Kings Hwy Department Of Family Medicine, Shreveport LA 71103-4228. He recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as his primary health care specialty. Gundaji, Jagadeeshwar can be contacted via phone (318) 675-5000.

Contact Information

Primary practice address
1501 Kings Hwy Department Of Family Medicine Shreveport LA 71103-4228
Phone: (318) 675-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1316158868
LBN Legal business name Gundaji, Jagadeeshwar
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2007
Last updated May 30th, 2008 - about 17 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 1316158868 NPPES
Louisiana MEDICAID 00019

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