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General NPI Number Information
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NPI Number | 1063629772
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Entity Type | Organization
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Legal Business Name | TRI-PARISH ORTHOPEDIC & NEUROSURGICAL INSTITUTE,LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 115 EUREKA DR
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City | GRAY
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State | LA
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Zip | 70359-3247
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Country | US
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Telephone | 985-873-1477
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Fax | 985-873-1545
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Provider Business Mailing Address
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Address Line | 115 EUREKA DR
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City | GRAY
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State | LA
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Zip | 70359-3247
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Country | US
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Telephone | 985-873-1477
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Fax | 985-873-1545
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Authorized Official
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Title or Position | OWNER
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Name | DR. PHILLIP V MCALLISTER
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Credential | M.D.
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Telephone | 985-873-1477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD15687R
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License Number State | LA
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