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Contact Information

MCLEOD GWYNETTE, MD
1541 KINGS HWY
SHREVEPORT, LA71103-4228
 Phone: 318-626-0000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for MCLEOD GWYNETTE · (Male)

NPI # 1750477881
Status Active
Credentials MD
Entity Individual
Enumeration date 10/05/2006
Last updated 07/23/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • LA License # 346503
  • SC License # TL29219
  • SC Medicaid 292196
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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