Fred A. Lord Jr., CRNA
Nurse Anesthetist, Certified Registered in Shreveport, LA. Individual provider (NPI-1).
NPI number1679792014
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1679792014
- Entity type
- Individual (NPI-1)
- Name
- Mr. Fred A. Lord Jr.
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 24, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 033348 | LA | Yes |
Practice location
745 Olive StSuite 100
Shreveport, LA 71104-2246
Phone 318-227-1163 · Fax 318-227-0413
Mailing address
243 Scarlett Pvt DrGloster, LA 71030
Phone 318-925-5826
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