| NPI | 1316957012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET T BURCHAM Credentialing Specialist 318-629-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 225X00000X Occupational Therapist | |
| 225XH1200X Occupational Therapist Hand | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant Medical | |
| 363AS0400X Physician Assistant Surgical | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| 207X00000X Orthopaedic Surgery | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-11-24 |