Provider Demographics
NPI:1538169420
Name:SKIN CARE SPECIALISTS APMC
Entity type:Organization
Organization Name:SKIN CARE SPECIALISTS APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:I
Authorized Official - Last Name:MCBURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-649-5880
Mailing Address - Street 1:1051 GAUSE BLVD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2951
Mailing Address - Country:US
Mailing Address - Phone:985-649-5880
Mailing Address - Fax:985-649-5369
Practice Address - Street 1:1051 GAUSE BLVD
Practice Address - Street 2:SUITE 460
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2951
Practice Address - Country:US
Practice Address - Phone:985-649-5880
Practice Address - Fax:985-649-5369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA053107207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA53940Medicare ID - Type UnspecifiedMCBURNEY PROVIDER #
LA5CC37Medicare ID - Type UnspecifiedHILTON PROVIDER #
LA5N717Medicare ID - Type UnspecifiedRAGLAND PROVIDER #