Healthcare Provider Details

I. General information

NPI: 1831025808
Provider Name (Legal Business Name): WOUND PROFESSIONAL SERVICES OF LOUISIANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 W CAUSEWAY APPROACH STE 2
MANDEVILLE LA
70471-3468
US

IV. Provider business mailing address

1590 W CAUSEWAY APPROACH STE 2
MANDEVILLE LA
70471-3468
US

V. Phone/Fax

Practice location:
  • Phone: 985-629-4043
  • Fax:
Mailing address:
  • Phone: 985-629-4043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAUN CARPENTER
Title or Position: CEO
Credential: MD
Phone: 985-629-4043