DP Wyatt LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

DP WYATT LLC

Practice address

708 North Ashley Ridge Loop Building 400
Shreveport, LA 71106

Phone

(318) 698-7000

Fax

(318) 698-7006

NPI assigned

May 6, 2022

Organization subpart

No

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

Authorized official

Name

Powell B Auer, MD

Title

Owner

Phone

(318) 990-9099

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1982340667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5237",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711355237",
            "telephone_number": "318-798-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 NORTH ASHLEY RIDGE LOOP BUILDING 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71106",
            "telephone_number": "318-698-7000",
            "fax_number": "318-698-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DP WYATT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "AUER",
        "authorized_official_first_name": "POWELL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-990-9099",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1305171",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Interventional Pain Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.