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Contact Information

DP WYATT LLC
708 NORTH ASHLEY RIDGE LOOP BUILDING 400
SHREVEPORT, LA71106
 Phone: 318-698-7000
 Fax: 318-698-7006
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for DP WYATT LLC

NPI # 1982340667
LBN Legal business name DP WYATT LLC
Authorized official POWELL AUER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/06/2022
Last updated 05/06/2022 - About 4 years ago
Identifiers
LA Medicaid 1305171
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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