CHUKA VICTOR IFEANYI (NPI# 1649407487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649407487 |
| Entity Type | Individual |
| Full Name | CHUKA VICTOR IFEANYI |
| Credential | M.D. |
| Practice Address |
1455 E Bert Koun Loop #206 Shreveport LA 71105-5634 |
| Practice Telephone | 3187984464 |
| Practice Fax Number | 3187984529 |
| Mailing Telephone | 3187984464 |
| Mailing Fax Number | 3187984529 |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2014-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 206975 | LA | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | R-8725 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2370146 | 05 |
| Street Address |
1455 E BERT KOUN LOOP #206 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821096686 | Charles Girard Tisdale | Physician Assistant | 1455 E Bert Koun Loop, #210, Shreveport, LA 71105-5634 | 2005-07-14 |
| 1770005423 | Heather Kramer Mecom | Nurse Practitioner | 1455 E Bert Koun Loop, Shreveport, LA 71105-5634 | 2017-07-14 |
| 1730555616 | Hillary Davis | Physician Assistant | 1455 E Bert Koun Loop, #210, Shreveport, LA 71105-5634 | 2015-08-14 |
| 1497010854 | Ashli M. Davis | Nurse Practitioner | 1455 E Bert Koun Loop, Shreveport, LA 71105-5634 | 2012-07-11 |
| 1295027787 | Sarah Lynn Scotto | Obstetrics & Gynecology | 1455 E Bert Koun Loop, Suite #308, Shreveport, LA 71105-5634 | 2011-05-03 |
| 1003090663 | Mansi Shah | Internal Medicine | 1455 E Bert Koun Loop, #210, Shreveport, LA 71105 | 2007-12-19 |
| 1891983144 | Kimberly Noland Lorant | Physician Assistant | 1455 E Bert Koun Loop, Suite #210, Shreveport, LA 71105-5634 | 2007-10-11 |
| 1902941099 | Solen Michael Austin | Physician Assistant | 1455 E Bert Koun Loop, Suite #210, Shreveport, LA 71105-5634 | 2007-02-20 |
| 1154349694 | Lauren P Scheffy | Physician Assistant | 1455 E Bert Koun Loop, Shreveport, LA 71105-5634 | 2006-07-17 |
| 1033158837 | James R Barnes | Internal Medicine | 1455 E Bert Koun Loop, Suite #105, Shreveport, LA 71105-5634 | 2006-06-06 |
| Find all providers in the same location | ||||
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396817722 | Kenneth W Sanders Pllc | Otolaryngology | 2800 Youree Drive, Suite 100a, Shreveport, LA 71104 | 2006-11-14 |
| 1639249337 | Doctors Hearing Center LLC Xxxiii | Otolaryngology | 8039 Line Ave, Shreveport, LA 71106 | 2006-11-09 |
| 1619960119 | Joseph Houston Bosley | Otolaryngology | 2533 Bert Kouns Industrial Loop, #104, Shreveport, LA 71118-3158 | 2005-08-30 |
| 1972509370 | Henry J Hollier | Otolaryngology | 2121 Line Ave, Shreveport, LA 71104-2126 | 2005-06-22 |
| 1215484647 | Ameya A. Asarkar | Otolaryngology | 1501 Kings Highway, Shreveport, LA 71130 | 2016-09-01 |
| 1306281613 | Mickie J. Hamiter | Otolaryngology | 1501 Kings Hwy, Oto, Shreveport, LA 71103-4228 | 2013-05-01 |
| 1881911683 | Paige Bundrick | Otolaryngology | 1501 Kings Hwy, Department of Otolaryngology, Shreveport, LA 71103-4228 | 2010-05-03 |
| 1225271513 | Blakely Nelson Thornton | Otolaryngology | 2121 Line Ave, Shreveport, LA 71104-2126 | 2009-04-15 |
| 1255581518 | Anil A Gungor | Otolaryngology | 1501 Kings Hwy, Department of Otolanyngology, Shreveport, LA 71103-4228 | 2008-09-23 |
| 1902097108 | Vikas Mehta | Otolaryngology | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2007-08-05 |
| Find all providers in SHREVEPORT | ||||
| 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.