Organization
MID LOUISIANA SURGICAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALEANA HOLDEN (ADMINISTRATOR)
(318) 442-6767
Entity
Organization
Contact information
Practice address
3311 PRESCOTT RD STE 201, ALEXANDRIA, LA 71301-3983
(318) 442-6767
(318) 441-1359
Mailing address
3311 PRESCOTT RD STE 201, ALEXANDRIA, LA 71301-3983
(318) 442-6767
(318) 441-1359
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1444545
—
LA
01
—
CK8221
RR MEDICARE
LA
01
—
G4276
BLUE CROSS GROUP
LA
Enumeration date
06/26/2006
Last updated
08/19/2022
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