Resneck, Jack S
Resneck, Jack S is an individual health care provider with primary practice located at 845 Olive St , Shreveport LA 71104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Resneck, Jack S can be contacted via phone (318) 222-3278.Contact Information
Primary practice address
845 Olive St
Shreveport LA 71104
Phone: (318) 222-3278
Fax: (318) 424-3155
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 01957 | Louisiana |
Profile Details
| NPI number | 1861475691 |
|---|---|
| LBN Legal business name | Resneck, Jack S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 25th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861475691 | NPPES |
| Louisiana | MEDICAID | 1143839 |
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