Joseph Michael Angelo, PA
Physician Assistant, Medical in Shreveport, LA. Individual provider (NPI-1).
NPI number1992831895
StatusActive
Last updated in NPPESFeb 3, 2025
Details
- NPI
- 1992831895
- Entity type
- Individual (NPI-1)
- Name
- Joseph Michael Angelo
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 26, 2007
- Certification date
- Feb 3, 2025
- Last updated
- Feb 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA.A10405 | LA | Yes |
Practice location
7925 Youree Dr Ste 200Shreveport, LA 71105-5134
Phone 318-212-3610 · Fax 318-212-3709
Mailing address
7925 Youree Dr Ste 200Shreveport, LA 71105-5134
Phone 318-212-3610 · Fax 318-212-3709
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