NPI 1477925063

Highland Clinic, a Prof Med Corp

Organisation Ophthalmology Physician Shreveport, LA

Practice location

Address: 471 Ashley Ridge Blvd, Shreveport, LA 71106-7229
Phone: (318) 795-4770
Fax: (318) 795-4775
Mailing address: 1455 E Bert Koun Loop, Shreveport, LA 71105-5634

Authorised official

Name: Michael Gustavson
Title: Administrator
Phone: (318) 798-4465

Registered specialties

Ophthalmology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207W00000X

Other Ophthalmology providers in Louisiana →

Registry record

NPI: 1477925063
Entity type: Organization
NPI issued: 22 Oct 2015
Record last updated: 2 Jun 2026

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.