Shattuck, Susan Marie
Shattuck, Susan Marie is an sole proprietor health care provider with primary practice located at 8001 Youree Dr Suite 350, Shreveport LA 71115-2302. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Shattuck, Susan Marie can be contacted via phone (318) 524-0114.Contact Information
Primary practice address
8001 Youree Dr Suite 350
Shreveport LA 71115-2302
Phone: (318) 524-0114
Fax: (318) 524-0195
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 013942 | Louisiana |
Profile Details
| NPI number | 1962409508 |
|---|---|
| LBN Legal business name | Shattuck, Susan Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2005 |
| Last updated | May 18th, 2011 - about 13 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 | 1962409508 | NPPES |
| Louisiana | MEDICAID | 1311421 |
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