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NPI Code Detail

MEDICARE: PARK PLAZA SURGICAL SPECIALISTS LLC

MEDICARE: PARK PLAZA SURGICAL SPECIALISTS 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
1207LP2900XPain Medicine (Anesthesiology) Physician
2261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1346871605
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARK PLAZA SURGICAL SPECIALISTS LLC
Provider Business Mailing Address
First Line : 8731 PARK PLAZA DR
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-5682
Country : US
Telephone Number : 318-797-5848
Fax Number :
Provider Business Practice Location Address
First Line : 8731 PARK PLAZA DR STE B
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-5682
Country : US
Telephone Number : 318-797-5848
Fax Number :
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : NICOLE M YOAKUM
Credential :
Telephone Number : 318-524-7144
Provider Enumeration Date : 01/27/2020
Last Update Date : 01/19/2026

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Directions to “PARK PLAZA SURGICAL SPECIALISTS LLC ” Practice Location

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