Kevin Paul Landry, CST/CSFA

Individual provider Active NPI Surgical Assistant · Maurice, LA

NPI 1811279128 · NPPES record last updated Sep 13, 2011

Key facts

NPI
1811279128
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Assistant 246ZC0007X
License
91262 (LA)
Practice address
301 Village Park Dr
Maurice, LA 70555-4441
Phone
(337) 517-8738
NPI assigned
Sep 13, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
91262LAMDSurgical Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 91262 LA Yes

Addresses

Primary practice location

301 Village Park Dr
Maurice, LA 70555-4441

Mailing address

301 Village Park Dr
Maurice, LA 70555-4441
Phone (337) 517-8738

Other providers in Maurice, LA

All providers in Maurice, LA · Surgical Assistant in Louisiana

Sources for this page

Verify at the official NPI Registry.