Southside Foot Clinic of Shreveport, Inc. a Professional Corporation
NPI #1033111240 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1033111240
- Entity Type
- Organization
- Organization Name
- Southside Foot Clinic of Shreveport, Inc. a Professional Corporation
- Primary Specialty
- Podiatrist - Foot & Ankle Surgery
- Enumeration Date
- Jun 1, 2005
- Last Updated
- Dec 29, 2025
Practice Location
- Address
- 9308 MANSFIELD RD
- Address 2
- STE 100
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71118-3134
- Phone
- (318) 687-6266
Authorized Official
- Name
- MR. RICHARD TAYLOR HAVENS, D.P.M.
- Title
- PHYSICIAN/ADMINISTRATOR
- Phone
- (318) 687-6266
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery |
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