Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 202146 | LA |
NPI | 1013132653 |
---|---|
Provider Name | Kyla Lokitz |
First Address | Shreveport, LA 71106-6131 |
Second Address | Shreveport, LA 71106-6131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1060828 | (05) | LA |
P01005688 | RAILROAD MEDICARE (01) | LA |