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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 months 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 1316171358 NPPES
Louisiana MEDICAID 2158210

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