EAR NOSE & THROAT CENTER A MEDICAL CORPORATION
NPI 1649350968
Otolaryngology in Shreveport, LA

Q: What is Ear Nose & Throat Center A Medical Corporation's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Active since October 17, 2006CLIA 19D0983739 · Waiver

2121 LINE AVE, SHREVEPORT, LA 71104(318) 226-9441(318) 425-3236 Get Directions Write a Review

NPPES record last updated: July 12, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ear Nose & Throat Center A Medical Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAR NOSE & THROAT CENTER A MEDICAL CORPORATION (NPI 1649350968) is a healthcare organization registered as an otolaryngology in Shreveport, Louisiana and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through February 28, 2027 and lists W. Juan Watkins, President, as its authorized official.

NPPES Registry Identity

NPI1649350968

Entity TypeOrganization

Primary Taxonomy207Y00000X

Legal Business NameEAR NOSE & THROAT CENTER A MEDICAL CORPORATION

Location Address2121 LINE AVEShreveport, LA 71104-2126

Mailing Address2121 Line AveShreveport, LA 71104-2126 · (318) 226-9441 · Fax (318) 425-3236

Phone(318) 226-9441

Fax(318) 425-3236

Organization SubpartNo

Authorized OfficialW. Juan WatkinsPresident · (318) 226-9441

Enumeration DateOctober 17, 2006

Last NPPES UpdateJuly 12, 2007

✔ NPI 1649350968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

2121 LINE AVE, Shreveport, LA 71104

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Other Identifiers 2

Medicaid1122262LA

Medicare ID-Type Unspecified5C056LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D0983739

Ear Nose & Throat Center, Amc · Shreveport, LA

Active · expires Feb 28, 2027

CLIA Number19D0983739

Laboratory TypePhysician Office

Certificate Effective DateMarch 1, 2025

Certificate Expiration DateFebruary 28, 2027

Laboratory DirectorW J. Watkins, MD

Laboratory Phone(318) 226-9441

Laboratory LocationEar Nose & Throat Center, Amc2121 Line Avenue, Shreveport, LA 71104

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM HARREL WATKINS M.D.

Otolaryngology