| The Skin Surgery Centre, Llc | |
|
1615 Metairie Rd Suite 101 Metairie LA 70005-3974 | |
| (504) 644-4226 | |
| Not Available |
| Full Name | The Skin Surgery Centre, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1615 Metairie Rd, Metairie, Louisiana |
| Authorized Official Name and Position | Keith G Leblanc (OWNER) |
| Authorized Official Contact | 5047562347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Skin Surgery Centre, Llc 1615 Metairie Rd Suite 101 Metairie LA 70005-3974 Ph: (504) 644-4226 | The Skin Surgery Centre, Llc 1615 Metairie Rd Suite 101 Metairie LA 70005-3974 Ph: (504) 644-4226 |
| NPI Number | 1730522087 |
|---|---|
| Provider Enumeration Date | 04/16/2013 |
| Last Update Date | 03/23/2017 |
| Medicare PECOS PAC ID | 5294969291 |
|---|---|
| Medicare Enrollment ID | O20131007000330 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730522087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Keith G Leblanc |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1972765493 PECOS PAC ID: 7012173438 Enrollment ID: I20131009000860 |
| Provider Name | Elizabeth F Bucher |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1295995546 PECOS PAC ID: 6103067236 Enrollment ID: I20150310000089 |
| Provider Name | Scott W Dunbar |
|---|---|
| Provider Type | Practitioner - Micrographic Dermatologic Surgery (mds) |
| Provider Identifiers | NPI Number: 1992029888 PECOS PAC ID: 3971731720 Enrollment ID: I20161021000357 |
| Provider Name | Randall Corey Rougelot |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1679815450 PECOS PAC ID: 8729202270 Enrollment ID: I20180618002410 |
| Provider Name | Surget Cox |
|---|---|
| Provider Type | Practitioner - Micrographic Dermatologic Surgery (mds) |
| Provider Identifiers | NPI Number: 1528509742 PECOS PAC ID: 5496096919 Enrollment ID: I20230620001987 |
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