Holly D. Casey, MD. a Professional Medical Corp.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

L14095R Issued in LA

Legal business name

HOLLY D. CASEY, MD. A PROFESSIONAL MEDICAL CORP.

Practice address

8600 Fern Avenue
Shreveport, LA 71105

Phone

(318) 795-0801

Fax

(318) 795-9492

NPI assigned

Oct 14, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Holly D. Casey, M.D.

Title

President

Phone

(318) 795-0801

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1174808794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 FERN AVENUE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-795-0801",
            "fax_number": "318-795-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 FERN AVENUE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-795-0801",
            "fax_number": "318-795-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY D. CASEY, MD. A PROFESSIONAL MEDICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-14",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-795-0801",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "L14095R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184306",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holliway Medical Clinic LLC
• Brondwyn Holliway, M.D.
• Linda Holloway, CCC-SLP
• Matthew Braxton Hollowell, RT(R)
• Holly D. Casey, MD, a Professional Medical Corp
• Latasha Nicole Holly, M.A.
• Hollywood Health Service
• Ronald Edward Holman, M.D.
• Courtney L Holmes Ukpabi, MSW, LMSW
• Annie Holmes

• Plastic and Reconstructive Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Plastic and Reconstructive Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.