Organization
BUNDRICK AND O'NEAL PLASTIC SURGERY (AMC)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL PATTERSON (OFFICE MANAGER)
(318) 221-9671
Entity
Organization
Contact information
Practice address
2210 LINE AVE, SUITE 204, SHREVEPORT, LA 71104-2152
(318) 221-9671
(318) 425-2343
Mailing address
2210 LINE AVE, SUITE 204, SHREVEPORT, LA 71104-2152
(318) 221-9671
(318) 425-2343
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1798908
—
LA
Enumeration date
03/28/2006
Last updated
06/27/2022
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