Organization · Type 2 NPI

Southside Foot Clinic of Shreveport Inc A Professional Corporation

Ambulatory Surgical Clinic/Center · Shreveport, LA

NPI number 1245215706 Active

Practice location

9308 Mansfield Rd, Suite 300
Shreveport, LA 71118-3134

Fax (318) 683-1023

Specialties and licenses

Taxonomy	Code	License
Ambulatory Surgical Clinic/Center Primary	261QA1903X	33 (LA)

Ambulatory Surgical Clinic/Center: Definition to come...

2 other providers at this address

Southside Foot Clinic of Shreveport, Inc. A Professional CorporationFoot & Ankle Surgery Podiatrist Shreveport, LA NPI 1033111240
Stephen Eugene Ertz, DPMPodiatrist Shreveport, LA NPI 1356321681

Other ambulatory surgical clinic/center providers in Shreveport

See all in Shreveport →

NPI record

NPI: 1245215706
Entity type: Organization (Type 2)
Issued: Dec 7, 2005
Last updated: Dec 29, 2025
Status: Active
Subpart: Yes of Southside Foot Clinic of Shreveport Inc A Professional Corporation

Other names

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The Foot Surgery Center of Shreveport · doing business as

Authorized official

Dr. Richard Taylor Havens, DPM
Administrator/physician
(318) 687-6266

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1245215706

Southside Foot Clinic of Shreveport Inc A Professional Corporation's National Provider Identifier is 1245215706, issued on Dec 7, 2005. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in Shreveport, LA. The record was last updated on Dec 29, 2025.