Physician Assistant, Surgical
643 EXTENDERS LLC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1821904863 · enumerated 2026-08-20 · record updated 2026-08-20. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Dr. JOHN GOOGE MD, President · (318) 629-5496
Addresses and phones
- Practice location 1500 LINE AVE STE 204, SHREVEPORT, LA, 71101-4648 (318) 629-5496 Google Maps Apple Maps OpenStreetMap
- Mailing address 717 CROCKETT ST, SHREVEPORT, LA, 71101-3605 (318) 629-5496 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant, Surgical 363AS0400X · Primary
In this directory
Locations and evidence
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Practice location
SHREVEPORT, LA, 711014648
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.