Susan Michelle Self, MD
Family Medicine in Shreveport, LA. Individual provider (NPI-1).
NPI number1023047149
StatusActive
Last updated in NPPESDec 18, 2007
Details
- NPI
- 1023047149
- Entity type
- Individual (NPI-1)
- Name
- Susan Michelle Self
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 1, 2006
- Last updated
- Dec 18, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 023219 | LA | Yes |
Practice location
8001 Youree DrSuite 540
Shreveport, LA 71115-2302
Phone 318-212-3810 · Fax 318-212-3815
Mailing address
8001 Youree DrSuite 540
Shreveport, LA 71115-2302
Phone 318-212-3810 · Fax 318-212-3815
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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