John M Provenza, MD
John M Provenza, MD is a Gastroenterology in Shreveport, Louisiana. Graduated from Louisiana State University School of Medicine in Shreveport in 1984, 42 years ago. Practices with Gi Specialists Hospitalists at Wkmc, a 12-clinician group and accepts Medicare assignment. Licensed in Louisiana.
- Years since qualifying
- 42
- Trained at
- Louisiana State University School of Medicine in Shreveport
- Licensed in
- LA
- In the registry since
- 2005
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
8383 Millicent Way Ste BShreveport, LA 71115
Phone: (318) 631-9121
Fax: (318) 213-6246
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Gastroenterology Physician (primary) | Taxonomy 207RG0100X · Licence 017860 (LA) |
|---|
Record details
| NPI number | 1225028434 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | October 27, 2005 |
| Last updated in NPPES | August 12, 2022 |
| Certification date | August 12, 2022 |
Medicare enrollment
| Medicare specialty | GASTROENTEROLOGY |
|---|---|
| Medical school | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduated | 1984 (42 years in practice) |
| Group practice | Gi Specialists Hospitalists At Wkmc — 12 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 5 on file with Medicare |
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