Individual
KASEY SCALLAN GORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 926-8686
Mailing address
LOCK BOX DEPT AT 952639, ATLANTA, GA 31192-2639
(800) 684-0857
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200623
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2346989
—
LA
Enumeration date
06/21/2013
Last updated
07/20/2016
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