Organization
HOLLY D. CASEY, MD. A PROFESSIONAL MEDICAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY D. CASEY M.D. (PRESIDENT)
(318) 795-0801
Entity
Organization
Contact information
Practice address
8600 FERN AVENUE, SHREVEPORT, LA 71105
(318) 795-0801
(318) 795-9492
Mailing address
8600 FERN AVENUE, SHREVEPORT, LA 71105
(318) 795-0801
(318) 795-9492
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
L14095R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184306
—
LA
Enumeration date
10/14/2011
Last updated
10/14/2011
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