NPI 1033111240

Southside Foot Clinic of Shreveport, INC. a Professional Corporation

Organisation Foot & Ankle Surgery Podiatrist Shreveport, LA

Practice location

Address: 9308 Mansfield Rd STE 100, Shreveport, LA 71118-3134
Phone: (318) 687-6266
Fax: (318) 683-1023

Authorised official

Name: Richard Taylor Havens
Title: Physician/Administrator
Phone: (318) 687-6266

Registered specialties

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 5B496 (LA)

Other Podiatrist providers in Louisiana →

Registry record

NPI: 1033111240
Entity type: Organization
NPI issued: 1 Jun 2005
Record last updated: 29 Dec 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.