Basic Information
| Provider Information | |||||||||
| NPI: | 1306409073 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARAWAY | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | ALLISON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2551 GREENWOOD RD STE 410 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711033989 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186212929 | ||||||||
| FaxNumber: | 3186212930 | ||||||||
| Practice Location | |||||||||
| Address1: | 2551 GREENWOOD RD STE 410 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711033989 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186212929 | ||||||||
| FaxNumber: | 3186212930 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2019 | ||||||||
| LastUpdateDate: | 08/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 331272 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.