Haughton, Gentry Lee
Haughton, Gentry Lee is an sole proprietor health care provider with primary practice located at 592 Unadilla St , Shreveport LA 71106-1240. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as her primary health care specialty. Haughton, Gentry Lee can be contacted via phone (318) 519-7555.Contact Information
Primary practice address
592 Unadilla St
Shreveport LA 71106-1240
Phone: (318) 519-7555
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | T07-2010 | Texas |
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 200048 | Louisiana |
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | T24-2008 | Texas |
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | T13-2009 | Texas |
Profile Details
NPI number | 1316171358 |
---|---|
LBN Legal business name | Haughton, Gentry Lee |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 5th, 2009 |
Last updated | Jul 18th, 2024 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1316171358 | NPPES |
Louisiana | MEDICAID | 2158210 |
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