LOUISIANA NEUROLOGIC CLINIC AMC (NPI# 1619969292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619969292 |
| Entity Type | Organization |
| Organization Name | LOUISIANA NEUROLOGIC CLINIC AMC |
| Practice Address |
1666 E Bert Kouns Loop Suite 140 Shreveport LA 71105-5714 |
| Practice Telephone | 3187975400 |
| Practice Fax Number | 3187975405 |
| Mailing Telephone | 3187975400 |
| Mailing Fax Number | 3187975405 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | DR. KRZYSZTOF K KUNDO (OWNER) |
| Authorized Official Telephone | 3187975400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | ========= | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1661970 | 05 |
| Street Address |
1666 E BERT KOUNS LOOP SUITE 140 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306838552 | Paul Michael Davis | Specialist | 1666 E Bert Kouns Loop, Suite 145, Shreveport, LA 71105-5714 | 2005-08-15 |
| 1750697314 | Plastic Surgery of Shreveport, Inc | Plastic Surgery | 1666 E Bert Kouns Loop, Ste 145, Shreveport, LA 71105-5714 | 2010-08-20 |
| 1912230244 | Wk Pierremont Psychiatry | Psychiatry & Neurology | 1666 E Bert Kouns Loop, Suite 220, Shreveport, LA 71105-5714 | 2009-09-18 |
| 1184884546 | G. Michelle Gray | Nurse Practitioner | 1666 E Bert Kouns Loop, Suite 225, Shreveport, LA 71105-5714 | 2008-06-10 |
| 1164514774 | Anesthesiology and Pain Management | Anesthesiology | 1666 E Bert Kouns Loop, Suite 125, Shreveport, LA 71105-5714 | 2006-09-29 |
| 1427088020 | Kathryn Kay Kennedy | Psychiatry & Neurology | 1666 E Bert Kouns Loop, Suite 220, Shreveport, LA 71105-5714 | 2006-07-03 |
| 1770519035 | Kay Kennedy Md and Willis-knighton Medical Center | Psychiatry & Neurology | 1666 E Bert Kouns Loop, Suite 220, Shreveport, LA 71105-5714 | 2006-06-25 |
| 1639115132 | Wk Urgent Care Center-pierremont | Internal Medicine | 1666 E Bert Kouns Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-06-22 |
| 1659367175 | Indira Sastry | Internal Medicine | 1666 E Bert Kouns Loop, Suite 225, Shreveport, LA 71105-5714 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437380342 | Stanley Hoang | Neurological Surgery | 1501 Kings Hwy Rm 3-407, Shreveport, LA 71103-4228 | 2009-07-28 |
| 1235330432 | Peter Gravel Campbell | Neurological Surgery | 1500 Line Ave Ste 200, Shreveport, LA 71101-4643 | 2007-05-29 |
| 1790720738 | Louisina State University Health Sciences Center | Neurological Surgery | 1501 Kings Highway, Lsuhsc-s, Shreveport, LA 71103-4228 | 2006-06-16 |
| 1598743734 | John David Reeves | Neurological Surgery | 2751 Albert L Bicknell Dr Ste 1b, Shreveport, LA 71103-3940 | 2006-01-06 |
| 1023506862 | Keisha Roichelle Bonyfield | Neurological Surgery | 1501 Kings Hwy, Shreveport, LA 71103 | 2018-04-26 |
| 1497277677 | Wk Spectrum Neurosurgery-the Brain & Spine Specialist | Neurological Surgery | 2751 Albert L Bicknell Dr Ste 1b, Shreveport, LA 71103-3940 | 2017-07-10 |
| 1497294375 | Amey Ragan Savardekar | Neurological Surgery | 1501 Kings Highway, Neurosurgery, Shreveport, LA 71130 | 2017-02-13 |
| 1760938278 | Wk Neurology Consultants | Neurological Surgery | 1202 Louisiana Ave, Shreveport, LA 71101-3910 | 2016-08-26 |
| 1649620238 | Nimer Abushehab | Neurological Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2016-06-15 |
| 1538513429 | Wk Tri- State Neurosurgery Associates | Neurological Surgery | 2551 Greenwood Rd, Suite 320, Shreveport, LA 71103-3981 | 2016-04-18 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on LOUISIANA NEUROLOGIC CLINIC AMC.
| 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.