Organization
FORD PLASTIC & RECONSTRUCTIVE SURGERY PMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE FORD CHIASSON MD (PRESIDENT)
(225) 269-2610
Entity
Organization
Contact information
Practice address
4864 BLUEBONNET BLVD, BATON ROUGE, LA 70809-9666
(225) 269-2610
(225) 269-2630
Mailing address
3330 CUMBERLAND BLVD SE STE 200, ATLANTA, GA 30339-5996
(770) 951-8427
(770) 951-2157
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD.206865
LICENSE
LA
Enumeration date
05/15/2020
Last updated
05/15/2020
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