Ursin, Susonne Annette

Ursin, Susonne Annette is an individual health care provider with primary practice located at 1501 Kings Hwy Department Of Pediatrics, Section Of Genetics, Shreveport LA 71103-4228. She recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), which is considered as her primary health care specialty. Ursin, Susonne Annette can be contacted via phone (318) 675-6076.

Contact Information

Primary practice address
1501 Kings Hwy Department Of Pediatrics, Section Of Genetics Shreveport LA 71103-4228
Phone: (318) 675-6076
Fax: (318) 675-6059
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) 207SG0201X 013853 Louisiana

Profile Details

NPI number 1700803608
LBN Legal business name Ursin, Susonne Annette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Jul 31st, 2009 - about 17 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 1700803608 NPPES
Louisiana MEDICAID 1194484

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