ELAINE BURGESS DICKSON

SHREVEPORT, LA
NPI1407044001
Former NameELAINE C BURGESS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: LA  PA200138)
Enumeration Date2007-10-09
Last Update Date2014-12-08
Business Address
-- ELAINE BURGESS DICKSON PA
1500 LINE AVE STE 100
SHREVEPORT, LA 71101
Phone number: 318-635-3052
Mailing Address
-- ELAINE BURGESS DICKSON PA
1534 ELIZABETH AVE SUITE 201
SHREVEPORT, LA 71101-4516
Phone number: 318-629-5002
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