Mary T Kim
Plastic and Reconstructive Surgery
1501 Kings Hwy
Shreveport
, Louisiana 71103-4228
Mary T Kim
Plastic and Reconstructive Surgery
1501 Kings Hwy
Shreveport
, Louisiana 71103-4228
(318) 675-6154
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Mary T Kim
- 1501 Kings Hwy
- Shreveport, LA
- Zip : 71103-4228
- Phone : (318) 675-6154
Second Address
- Mary T Kim
- 1501 Kings Hwy
- Shreveport, LA
- Zip : 71103-4228
- Phone : (318) 675-6154
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | MD200563 | LA |
National Provider Identifier
| NPI | 1033192828 |
|---|---|
| Provider Name | Mary T Kim |
| First Address | Shreveport, LA 71103-4228 |
| Second Address | Shreveport, LA 71103-4228 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/11/2005 |
| Last Update Date | 18/05/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1581518 | (05) | LA |
| I48330 | (02) | LA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.