Healthcare Provider Details

I. General information

NPI: 1144005307
Provider Name (Legal Business Name): MCGEE PLASTIC SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 SILVERSTONE RD STE 106A
LAFAYETTE LA
70508-6899
US

IV. Provider business mailing address

605 SILVERSTONE RD STE 106A
LAFAYETTE LA
70508-6899
US

V. Phone/Fax

Practice location:
  • Phone: 337-205-2262
  • Fax: 337-270-7039
Mailing address:
  • Phone: 337-534-4058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JACK MCGEE
Title or Position: CLINIC MANAGER
Credential: JD
Phone: 337-303-7299