Southside Foot Clinic of Shreveport INC a Professional Corporation
NPI #1245215706 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1245215706
- Entity Type
- Organization
- Organization Name
- Southside Foot Clinic of Shreveport INC a Professional Corporation
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Dec 7, 2005
- Last Updated
- Dec 29, 2025
Practice Location
- Address
- 9308 MANSFIELD RD
- Address 2
- SUITE 300
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71118-3134
- Phone
- (318) 687-6266
Authorized Official
- Name
- DR. RICHARD TAYLOR HAVENS, DPM
- Title
- ADMINISTRATOR/PHYSICIAN
- Phone
- (318) 687-6266
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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