Kevin M. Sittig M.D.
Pediatric Surgery Physician in Shreveport, LA(View on Map)
Full Name
Kevin Mark Sittig M.D.
NPI Number
1104846989
NPI Type
Individual Provider
Gender
Male
Enumeration Date
07/21/2006
Specialties
(Taxonomies)Code
2086S0120X
208600000X
2086S0102X
Primary Taxonomy
Yes
No
No
Licenses
State
Louisiana
License Number
017190
Contact
Information
Purpose
Mailing
Location
Address
1512 W KIRBY PL
1541 KINGS HWY DEPT OF
City
Shreveport
Shreveport
State
LA
LA
Postal Code
71103-3822
71103-4228
Country
US
US
Telephone Number
(318) 626-0287
(318) 813-2655
Identifiers
Identifier
55714F600
1386138
Identifier State
LA
LA
Identifier Issuer
MEDICARE - PTAN
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/26/2020
Provider Address
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