Kim, Mary T
Kim, Mary T is an sole proprietor health care provider with primary practice located at 1501 Kings Hwy , Shreveport LA 71103-4228. She recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as her primary health care specialty. Kim, Mary T can be contacted via phone (318) 675-6154.Contact Information
Primary practice address
1501 Kings Hwy
Shreveport LA 71103-4228
Phone: (318) 675-6154
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | MD200563 | Louisiana |
Profile Details
| NPI number | 1033192828 |
|---|---|
| LBN Legal business name | Kim, Mary T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 25th, 2005 |
| Last updated | May 18th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033192828 | NPPES |
| Louisiana | MEDICAID | 1581518 |
Popular Providers
-
Rogers, James H
3320 Sw 34Th Cir , Ocala FL 34474-3371 -
Asokan, Rangaswamy
2651 Sw 32Nd Pl , Ocala FL 34471 -
Wall, Simeon
8600 Fern Ave , Shreveport LA 71105-5639 -
Ghali, Ghali Elias
2508 Bert Kouns Industrial Loop , Shreveport LA 71118 -
Van Aalst-Barker, Vera C
901 Dupont Rd Ste 202, Louisville KY 40207-4644 -
Banis, Joseph C.
2507 Bush Ridge Dr Ste B , Louisville KY 40245-5885 -
Wall, Forrest P
385 Bert Kouns Industrial Loop Ste 100 , Shreveport LA 71106-8159 -
Mobley, David Winton
5101 Gate Parkway Suite 2, Jacksonville FL 32256-7276