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Contact Information

ALFRED W. HATHORN JR., M.D. APMC
2120 BERT KOUN LOOP
SUITE # L
SHREVEPORT, LA71118-3351
 Phone: 318-686-8197
 Fax: 318-688-5962
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ALFRED W HATHORN JR MD APMC · (Female)

NPI # 1487066296
Status Active
Credentials
Entity Individual
Enumeration date 05/28/2014
Last updated 05/28/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA License # 011400
  • LA License # AP06110
  • LA Medicaid 1135127
  • LA Medicaid 2315889
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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