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Search › Louisiana › 207R00000X

Russell Tynes, MD

NPI 1851323810 · on the registry since 2006 · sole proprietor

Practice

Address
460 Ashley Ridge Blvd
500
Shreveport, LA 71106
Phone
(318) 212-1610
Fax
(866) 455-7515
Organisation at this address
Ivy Dental
Cds Ashley Ridge
White Clover, Llc
Jct Medical Consulting
Catherine F Vanderloos
Inferred from a shared address, not stated in the registry.
Clinicians at this address
9

Registry record

Primary taxonomy
207R00000X
207R00000X
Licence states on file
LA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2009-04-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana