Provider Demographics
NPI:1235860404
Name:THE PLASTIC RECONSTRUCTIVE AND COSMETIC INDEPENDENT PHYSICIANS ASSOCIA
Entity Type:Organization
Organization Name:THE PLASTIC RECONSTRUCTIVE AND COSMETIC INDEPENDENT PHYSICIANS ASSOCIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:VEULEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-239-6328
Mailing Address - Street 1:PO BOX 750443
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70175-0443
Mailing Address - Country:US
Mailing Address - Phone:504-208-2534
Mailing Address - Fax:
Practice Address - Street 1:5233 DIJON DR STE D
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4693
Practice Address - Country:US
Practice Address - Phone:225-767-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty