Havens, Richard Taylor

Havens, Richard Taylor is an individual health care provider with primary practice located at 9308 Mansfield Rd Ste 100 , Shreveport LA 71118-3134. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Havens, Richard Taylor can be contacted via phone (318) 687-6266.

Contact Information

Primary practice address
9308 Mansfield Rd Ste 100 Shreveport LA 71118-3134
Fax: (318) 683-1023
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PDR073R Louisiana

Profile Details

NPI number 1285643908
LBN Legal business name Havens, Richard Taylor
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Aug 4th, 2010 - about 15 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 1285643908 NPPES
Louisiana MEDICAID 1384691

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