Organization
PLASTIC SURGERY ASSOCIATES OF SOUTHWEST LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE CHOLLEY (OFFICE MANAGER)
(337) 497-1958
Entity
Organization
Contact information
Practice address
4150 NELSON RD, BLDG D STE 2B, LAKE CHARLES, LA 70605-4148
(337) 497-1958
(337) 433-4024
Mailing address
PO BOX 2085, LAKE CHARLES, LA 70602-2085
(337) 497-1958
(337) 433-4024
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1330663
—
LA
05
—
1978671
—
LA
Enumeration date
03/07/2007
Last updated
08/22/2020
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