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Contact Information

JACK S RESNECK, MD
845 OLIVE ST
SHREVEPORT, LA71104
 Phone: 318-222-3278
 Fax: 318-424-3155
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for JACK S RESNECK · (Male)

NPI # 1861475691
Status Active
Credentials MD
Entity Individual
Enumeration date 11/25/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA License # 01957
  • LA Medicaid 1143839
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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