Healthcare Provider Details

I. General information

NPI: 1831397439
Provider Name (Legal Business Name): ASSOCIATED SURGICAL SPECIALISTS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 LAKEVIEW CT SUITE A
COVINGTON LA
70433-7514
US

IV. Provider business mailing address

350 LAKEVIEW CT SUITE A
COVINGTON LA
70433-7514
US

V. Phone/Fax

Practice location:
  • Phone: 985-845-2677
  • Fax: 985-867-5498
Mailing address:
  • Phone: 985-845-2677
  • Fax: 985-867-5498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN C BEATROUS
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 985-845-2677