Individual provider · NPI-1

Kasi M. Addison, DO

Emergency Medicine · Shreveport, LA

NPI number1679034870
StatusActive
Last updated in NPPESOct 10, 2024

Details

NPI
1679034870
Entity type
Individual (NPI-1)
Name
Kasi M. Addison
Credential
DO
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 29, 2019
Certification date
Oct 10, 2024
Last updated
Oct 10, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency MedicineT5504TXYes
207P00000X Emergency Medicine328079LA

Practice location

1541 Kings Highway
Emergency Medicine
Shreveport, LA 71130-3932

Phone 318-626-2326

Mailing address

1541 Kings Highway
Emergency Medicine
Shreveport, LA 71130-3932

Phone 318-626-2326

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