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SF

SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION

Adult Day Care

OIG CLEARNPI VERIFIED
Location
SHREVEPORT, LA
Licensed since
2005
Rate
Federal identifiers
NPI registry number1245215706
Agency details
Parent orgSOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION
Medicare activity
StatusNo Medicare utilization on file — neutral.
RevalidationDue 2026-04-30
Authorized official
NameRICHARD HAVENS
TitleADMINISTRATOR/PHYSICIAN
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