Callegan-Poche', Amanda Lynn
Callegan-Poche', Amanda Lynn is an individual health care provider with primary practice located at 1023 Provenance Pl Ste 130 , Shreveport LA 71106-7796. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Callegan-Poche', Amanda Lynn can be contacted via phone (318) 626-0000.Contact Information
Primary practice address
1023 Provenance Pl Ste 130
Shreveport LA 71106-7796
Phone: (318) 626-0000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 312618 | Louisiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 312618 | Louisiana |
Profile Details
| NPI number | 1265829394 |
|---|---|
| LBN Legal business name | Callegan-Poche', Amanda Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 15th, 2015 |
| Last updated | Sep 27th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265829394 | NPPES |
| Louisiana | MEDICAID | 2388312 |
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