Pryor, Evelyn Baranco

Pryor, Evelyn Baranco is an individual health care provider with primary practice located at 1541 Kings Hwy , Shreveport LA 71103-4228. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Pryor, Evelyn Baranco can be contacted via phone (318) 626-0000.

Contact Information

Primary practice address
1541 Kings Hwy Shreveport LA 71103-4228
Phone: (318) 626-0000
Fax: (318) 629-4833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 053976 Georgia
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 326734 Louisiana

Profile Details

NPI number 1619977592
LBN Legal business name Pryor, Evelyn Baranco
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Aug 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619977592 NPPES
Georgia MEDICAID 149934368B
Georgia MEDICAID 1619977592
Georgia MEDICAID Q0158H
Georgia MEDICAID 5905358
Georgia Other P00378172

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