Provider Demographics
NPI:1376033118
Name:ALBIN, ALEXIS VICTORIA GUICE (MD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:VICTORIA GUICE
Last Name:ALBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1501 KINGS HIGHWAY
Mailing Address - Street 2:INTERNAL MEDICINE/PEDIATRICS
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71130
Mailing Address - Country:US
Mailing Address - Phone:318-626-0436
Mailing Address - Fax:
Practice Address - Street 1:3400 MEDICAL PARK DR STE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-2300
Practice Address - Country:US
Practice Address - Phone:183-876-8033
Practice Address - Fax:318-387-6874
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330854208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatrics