Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southside Foot Clinic of Shreveport, Inc a Professional Corporation

Organization Foot & Ankle Surgery Podiatrist · NPI 1033111240

Southside Foot Clinic of Shreveport, Inc a Professional Corporation is a Foot & Ankle Surgery Podiatrist in Shreveport, Louisiana. Licensed in Louisiana. Registered with an NPI since 2005.

Licensed in
LA
In the registry since
2005
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

9308 Mansfield Rd Ste 100
Shreveport, LA 71118-3134
Phone: (318) 687-6266
Fax: (318) 683-1023
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 5B496 (LA)

Record details

NPI number1033111240
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Havens — Physician/Administrator · (318) 687-6266
Other names Southside Foot Clinic
NPI enumeratedJune 1, 2005
Last updated in NPPESDecember 29, 2025
Certification dateDecember 29, 2025
Mailing address9308 Mansfield Rd, Ste 100, Shreveport, LA 71118-3134

Other providers in Shreveport