FORD PLASTIC & RECONSTRUCTIVE SURGERY PMC (NPI# 1265054969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265054969 |
| Entity Type | Organization |
| Organization Name | FORD PLASTIC & RECONSTRUCTIVE SURGERY PMC |
| Practice Address |
4864 Bluebonnet Blvd Baton Rouge LA 70809-9666 |
| Mailing Address |
3330 Cumberland Blvd Se Ste 200 Atlanta GA 30339-5996 |
| Practice Telephone | 2252692610 |
| Practice Fax Number | 2252692630 |
| Mailing Telephone | 7709518427 |
| Mailing Fax Number | 7709512157 |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |
| Authorized Official Name | KATHERINE FORD CHIASSON (PRESIDENT) |
| Authorized Official Telephone | 2252692610 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | LICENSE | MD.206865 | 01 |
| Street Address |
4864 BLUEBONNET BLVD |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70809-9666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437317260 | Elizabeth A Clubb | Specialist | 4864 Bluebonnet Blvd, Suite A, Baton Rouge, LA 70809-9644 | 2008-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582640 | Lisha Kerr Jacobsen | Counselor | 7936 Wrenwood Drive, Bldg # A, Baton Rouge, LA 70809 | 2020-09-15 |
| 1790301596 | Louisiana Regenerative Medicine Center | Clinic/Center | 9456 Jefferson Hwy St A, Baton Rouge, LA 70809 | 2020-06-18 |
| 1093337305 | Sew Luxe Customs, LLC | Prosthetic/Orthotic Supplier | 8674 Quarters Lake Road, Building 11 Suit 1, Baton Rouge, LA 70809 | 2020-05-08 |
| 1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
| 1548734213 | Urg-hab Surgical Specialists | Pain Medicine | 8558 Jefferson Hwy, Baton Rouge, LA 70809 | 2019-01-16 |
| 1205306610 | Monique West | Case Manager/Care Coordinator | 9441 Common Street, Suite B, Baton Rouge, LA 70809 | 2018-11-28 |
| 1679061618 | Sara Elizabeth Nicole Altaean | Massage Therapist | Ability Massage & Day Spa, 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-04-25 |
| 1871098921 | Gary Bernard Jr. | Massage Therapist | 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-03-29 |
| 1619476355 | De'andria Banks | Behavior Technician | 9150 Bareford Drive, Baton Rouge, LA 70809 | 2018-02-08 |
| 1427561679 | Angiogenesis Medical LLC | Durable Medical Equipment & Medical Supplies | 8032 Summa Ave Ste D, Baton Rouge, LA 70809 | 2017-11-09 |
| Find all providers in zip 70809 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942590153 | Jenna Martin Bourgeois | Surgery | Associates In Plastic Surgery, 8425 Cumberland Place, Baton Rouge, LA 70806 | 2011-04-10 |
| 1295808863 | James W Wade | Surgery | 5233 Dijon Drive, Baton Rouge, LA 70817 | 2006-11-15 |
| 1851882997 | Cusimano Plastic Surgery LLC | Surgery | 7777 Hennessy Blvd Ste 102, Baton Rouge, LA 70808-4363 | 2018-05-24 |
| 1396062030 | Luke Anthony Cusimano IIi | Surgery | 7777 Hennessy Blvd Ste 102, Baton Rouge, LA 70808-4363 | 2010-04-20 |
| 1629112560 | John Vincent Williams | Surgery | 8777 Bluebonnet Blvd, Suite A, Baton Rouge, LA 70810-2818 | 2007-02-16 |
| 1326180696 | Our Lady of The Lake Hospital Inc | Surgery | 7777 Hennessy Blvd, Plaza 1 Suite 306, Baton Rouge, LA 70808 | 2007-02-13 |
| 1801887500 | Wendell H Kisner | Surgery | 7777 Hennessy Blvd, Baton Rouge, LA 70808-4300 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430257 | Thibodaux Regional Network Development Corporation | Surgery | 604 N Acadia Rd Ste 410, Thibodaux, LA 70301-4897 | 2020-06-03 |
| 1710121306 | John P Guste | Surgery | 3900 Veterans Blvd., Suite 200, Metairie, LA 70002 | 2009-04-27 |
| 1700929874 | The Plastic Surgery Center LLP | Surgery | 385 Bert Kouns Ind. Loop, Bldg 100, Shreveport, LA 71106-8124 | 2007-02-15 |
| 1861595969 | Terry A Cromwell | Surgery | 1101 South College Road, Suite 400, Lafayette, LA 70503 | 2006-09-06 |
| 1154344000 | Scott Keith Sullivan Jr. | Surgery | 1717 Saint Charles Ave, New Orleans, LA 70130-5223 | 2006-07-25 |
| 1568482339 | Herbert Stephen Maguire | Surgery | 501 Medical Center Dr Ste 1b, Alexandria, LA 71301-8124 | 2006-07-21 |
| 1346260205 | O'neil Joseph Engeron | Surgery | 615 Dunn St, Houma, LA 70360-4707 | 2006-07-20 |
| 1912936196 | Kenneth W. Sanders, Md and Willis-knighton Medical Center | Surgery | 1811 East Bert Kouns, Suite 160, Shreveport, LA 71105-5505 | 2006-07-01 |
| 1134190465 | Ralph W Colpitts | Surgery | 2000 Southwood Dr, Suite B, Lake Charles, LA 70605-4138 | 2006-01-26 |
| 1699758474 | Forrest P Wall | Surgery | 385 Bert Kound Ind. Loop, Bldg 100, Shreveport, LA 71106-8124 | 2005-11-25 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70809 |
Please comment or provide details below to improve the information on FORD PLASTIC & RECONSTRUCTIVE SURGERY PMC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.