MEDICARE: TRI-PARISH ORTHOPEDIC & NEUROSURGICAL INSTITUTE,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD15687R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063629772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-PARISH ORTHOPEDIC & NEUROSURGICAL INSTITUTE,LLC

Provider Business Mailing Address
First Line	:	115 EUREKA DR
Second Line	:
City	:	GRAY
State	:	LA
Zip	:	70359-3247
Country	:	US
Telephone Number	:	985-873-1477
Fax Number	:	985-873-1545

Provider Business Practice Location Address
First Line	:	115 EUREKA DR
Second Line	:
City	:	GRAY
State	:	LA
Zip	:	70359-3247
Country	:	US
Telephone Number	:	985-873-1477
Fax Number	:	985-873-1545

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PHILLIP V MCALLISTER
Credential	:	M.D.
Telephone Number	:	985-873-1477

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	10/10/2012

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