# SURGASSIST OF SHREVEPORT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356722466
- **Authorized official:** GEORGE MERRIMAN MD (OWNER)
- **Authorized official phone:** (318) 222-3132

## Contact information

- **Practice address:** 949 OLIVE ST, SHREVEPORT, LA 71104-2103
- **Practice address phone:** (318) 222-3132
- **Practice address fax:** (318) 222-3865
- **Mailing address:** 949 OLIVE ST, SHREVEPORT, LA 71104-2103
- **Mailing address phone:** (318) 222-3132
- **Mailing address fax:** (318) 222-3865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | PA.200749 | LA | Yes |

## Other

- **Enumeration date:** 06/15/2015
- **Last updated:** 07/27/2016