Kenneth Betzing PA-C

NPI 1053304048 - Physician Assistant - 363A00000X

NPI Details
NPI 1053304048
Gender Male
Enumeration Date 08/25/2005
Last Updated 05/08/2013
Entity Type Individual
Active Over 11 years ago
Practice Location
1455 E BERT KOUNS LOOP
SHREVEPORT LA, 71105-5634, US
Phone (318) 798-4573
Fax (318) 798-4651
Business Location
1455 E BERT KOUNS LOOP
SHREVEPORT LA, 71105-5634, US
Phone (318) 798-4573
Fax (318) 798-4651
Toxanomy
Taxonomy Code 363A00000X
License State Louisiana
License Number PA.A10262.RX
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According to our database, Kenneth Betzing PA-C NPI is 1053304048, taxonomy code is 363A00000X and license number is PA.A10262.RX, license state is located at Louisiana. Kenneth Betzing PA-C physically located at 1455 E Bert Kouns Loop, Shreveport LA, 71105-5634. NPI Number Kenneth Betzing PA-C has the Individual type.

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1053304048 NPI number is provided on an as is basis without warranty of any kind. 1053304048 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth Betzing PA-C are for informational purposes only.