Pryor, Evelyn Baranco
Pryor, Evelyn Baranco is an individual health care provider with primary practice located at 1541 Kings Hwy , Shreveport LA 71103-4228. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Pryor, Evelyn Baranco can be contacted via phone (318) 626-0000.Contact Information
Primary practice address
1541 Kings Hwy
Shreveport LA 71103-4228
Phone: (318) 626-0000
Fax: (318) 629-4833
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 053976 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 326734 | Louisiana |
Profile Details
| NPI number | 1619977592 |
|---|---|
| LBN Legal business name | Pryor, Evelyn Baranco |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2005 |
| Last updated | Aug 17th, 2023 - 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 | 1619977592 | NPPES |
| Georgia | MEDICAID | 149934368B | |
| Georgia | MEDICAID | 1619977592 | |
| Georgia | MEDICAID | Q0158H | |
| Georgia | MEDICAID | 5905358 | |
| Georgia | Other | P00378172 |
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