Healthcare Provider Details

I. General information

NPI: 1922268994
Provider Name (Legal Business Name): SURESHKUMAR HIMATLAL BHATT M.D.,FCCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 05/01/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 E VETERANS MEML DR
KAPLAN LA
70548-5009
US

IV. Provider business mailing address

PO BOX 85
KAPLAN LA
70548-0085
US

V. Phone/Fax

Practice location:
  • Phone: 337-643-8424
  • Fax: 337-643-8407
Mailing address:
  • Phone: 337-643-8424
  • Fax: 337-643-8407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD500002487
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD.204609
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: