THE PLASTIC SURGERY CENTER LLP (NPI# 1700929874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700929874 |
| Entity Type | Organization |
| Organization Name | THE PLASTIC SURGERY CENTER LLP |
| Practice Address |
385 Bert Kouns Ind. Loop, Bldg 100 Shreveport LA 71106-8124 |
| Practice Telephone | 3182211629 |
| Mailing Telephone | 3182211629 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-10-24 |
| Authorized Official Name | DR. FORREST WALL (OWNER) |
| Authorized Official Telephone | 3182211629 |
| Authorized Official Credential | M.D. |
| 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 |
| Street Address |
385 BERT KOUNS IND. LOOP, BLDG 100 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-8124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| 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 |
|---|---|---|---|---|
| 1912936196 | Kenneth W. Sanders, Md and Willis-knighton Medical Center | Surgery | 1811 East Bert Kouns, Suite 160, Shreveport, LA 71105-5505 | 2006-07-01 |
| 1699758474 | Forrest P Wall | Surgery | 385 Bert Kound Ind. Loop, Bldg 100, Shreveport, LA 71106-8124 | 2005-11-25 |
| 1679555072 | Stephen Jon Ramey | Surgery | 1505 E Bert Kouns Industrial Loop # 101, Shreveport, LA 71105-5723 | 2005-11-19 |
| 1245229624 | Holly Casey Wall | Surgery | 8600 Fern Ave, Shreveport, LA 71105-5639 | 2005-10-18 |
| 1861496556 | Daniel R Knight | Surgery | 2533 Bert Kouns Industrial Loop Ste 106, Shreveport, LA 71118-3158 | 2005-06-09 |
| 1174808794 | Holly D. Casey, Md. A Professional Medical Corp. | Surgery | 8600 Fern Avenue, Shreveport, LA 71105 | 2011-10-14 |
| 1851563464 | Neurotrix, Inc. | Surgery | 1657 E 70th St, Shreveport, LA 71105-5115 | 2008-03-24 |
| 1033192828 | Mary T Kim | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-11-25 |
| 1275522682 | Simeon Wall Jr. | Surgery | 8600 Fern Ave, Shreveport, LA 71105-5639 | 2005-10-18 |
| 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 |
| 1942590153 | Jenna Martin Bourgeois | Surgery | Associates In Plastic Surgery, 8425 Cumberland Place, Baton Rouge, LA 70806 | 2011-04-10 |
| 1710121306 | John P Guste | Surgery | 3900 Veterans Blvd., Suite 200, Metairie, LA 70002 | 2009-04-27 |
| 1295808863 | James W Wade | Surgery | 5233 Dijon Drive, Baton Rouge, LA 70817 | 2006-11-15 |
| 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 |
| 1134190465 | Ralph W Colpitts | Surgery | 2000 Southwood Dr, Suite B, Lake Charles, LA 70605-4138 | 2006-01-26 |
| 1265054969 | Ford Plastic & Reconstructive Surgery Pmc | Surgery | 4864 Bluebonnet Blvd, Baton Rouge, LA 70809-9666 | 2020-05-15 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
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| 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.