Organization · Type 2 NPI
643 Extenders LLC
Surgical Physician Assistant · Shreveport, LA
NPI number
1821904863
Active
Practice location
1500 Line Ave Ste 204
Shreveport, LA 71101-4648
Mailing address
717 Crockett St
Shreveport, LA 71101-3605
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
Other surgical physician assistant providers in Shreveport
About NPI 1821904863
643 Extenders LLC's National Provider Identifier is 1821904863, issued on Aug 20, 2026. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Shreveport, LA. The record was last updated on Aug 20, 2026.