Provider Demographics
NPI:1942359526
Name:SPENCER LOVITT
Entity Type:Organization
Organization Name:SPENCER LOVITT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:HEATH
Authorized Official - Last Name:LOVITT
Authorized Official - Suffix:
Authorized Official - Credentials:C-PED
Authorized Official - Phone:318-687-7317
Mailing Address - Street 1:8837 KINGSTON RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2207
Mailing Address - Country:US
Mailing Address - Phone:318-687-7317
Mailing Address - Fax:318-687-0916
Practice Address - Street 1:8837 KINGSTON RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2207
Practice Address - Country:US
Practice Address - Phone:318-687-7317
Practice Address - Fax:318-687-0916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5379740001Medicare NSC