Provider Demographics
NPI:1013132653
Name:LOKITZ, KYLA (MD)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:LOKITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8508 LINE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-6131
Mailing Address - Country:US
Mailing Address - Phone:318-219-7704
Mailing Address - Fax:318-219-7752
Practice Address - Street 1:8508 LINE AVE STE C
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-6131
Practice Address - Country:US
Practice Address - Phone:318-219-7704
Practice Address - Fax:318-219-7752
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202146207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP01005688OtherRAILROAD MEDICARE
LA1060828Medicaid
LA4Q178DT91Medicare PIN