Provider Demographics
NPI:1417943440
Name:FERRELL, JOHN J (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:FERRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7925 YOUREE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5538
Mailing Address - Country:US
Mailing Address - Phone:318-424-3400
Mailing Address - Fax:318-841-0410
Practice Address - Street 1:7925 YOUREE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5538
Practice Address - Country:US
Practice Address - Phone:318-424-3400
Practice Address - Fax:318-841-0410
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2021-06-24
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Provider Licenses
StateLicense IDTaxonomies
LA015264207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1363197Medicaid
LA1363197Medicaid
LAB62064Medicare UPIN
LA5M874Medicare PIN