John M Provenza, M.D.
NPI #1225028434 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1225028434
- Entity Type
- Individual
- Name
- John M Provenza, M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Internal Medicine - Gastroenterology
- Credential
- M.D.
- Enumeration Date
- Oct 27, 2005
- Last Updated
- Aug 12, 2022
Practice Location
- Address
- 8383 MILLICENT WAY STE B
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71115
- Phone
- (318) 631-9121
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Gastroenterology — Gastroenterology |
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