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Individual

DR. WENDELL H KISNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7777 HENNESSY BLVD, BATON ROUGE, LA 70808-4300
(225) 765-4454
(225) 765-4288
Mailing address
16025 HIGHLAND BLUFF CT, BATON ROUGE, LA 70810-5630
(225) 892-5602
(225) 765-4288

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
MD.010138
LA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
010138
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1150436
LA
Enumeration date
11/02/2005
Last updated
12/19/2021
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