SKIN SURGERY SPECIALISTS (NPI# 1083953137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083953137 |
| Entity Type | Organization |
| Organization Name | SKIN SURGERY SPECIALISTS |
| Practice Address |
8575 Business Park Dr Shreveport LA 71105-5655 |
| Mailing Address |
10884 Dauphine St Shreveport LA 71106-8523 |
| Practice Telephone | 6784488276 |
| Enumeration Date | 2013-02-10 |
| Last Update Date | 2013-07-18 |
| Authorized Official Name | DR. JAMES KEANE (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 6784488276 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD.205964 | LA | Allopathic & Osteopathic Physicians |
| Street Address |
8575 BUSINESS PARK DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184147498 | Enid Holdings LLC | Dermatology | 4501 N I 10 Service Rd W, Metairie, LA 70006-6525 | 2017-07-18 |
| 1871726000 | Maurice Mccall Vick Jr. | Dermatology | 5225 Odonovan, Ste 102, Baton Rouge, LA 70808-7202 | 2009-09-04 |
| 1407039050 | Nicholas J. Viviano, Md, LLC | Dermatology | 7031 Highway 190 East Service Rd, Covington, LA 70433-4955 | 2007-12-05 |
| 1356421010 | The Dermatology Clinic of St Tammany II, LLC | Dermatology | 714 W 16th Ave, Covington, LA 70433-2422 | 2006-10-17 |
| 1467541797 | Carter David Paddock | Dermatology | 6640 Riverside Dr, Suite 230, Metairie, LA 70003 | 2006-10-12 |
| 1184711194 | John H Counce II | Dermatology | 3901 Houma Blvd., Suite 109, Metairie, LA 70006 | 2006-10-10 |
| 1861585283 | William P. Coleman IIi | Dermatology | 4425 Conlin St, Metairie, LA 70006-2123 | 2006-09-30 |
| 1861459547 | Rene None Koppel | Dermatology | 3640 Houma Blvd, Metairie, LA 70006-4230 | 2006-04-27 |
| 1487615662 | Jack P Murphy | Dermatology | 398 Belle Terre Blvd, La Place, LA 70068-2435 | 2006-03-29 |
| 1841269453 | Thomas Drew Carey | Dermatology | 410 E Vaughn Ave, Ruston, LA 71270-5951 | 2006-03-16 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.