Provider Demographics
NPI:1811973431
Name:CLINE, DEBRA P (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:P
Last Name:CLINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1315 FOREST CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-9548
Mailing Address - Country:US
Mailing Address - Phone:318-798-8273
Mailing Address - Fax:
Practice Address - Street 1:2600 KINGS HWY STE 420
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3950
Practice Address - Country:US
Practice Address - Phone:318-212-8727
Practice Address - Fax:318-212-8771
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.021956207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1494054Medicaid
LA1494054Medicaid
LA5Y438Medicare ID - Type Unspecified