DR. WALLACE HAROLD BROWN M.D. NPI 1114988995

NPI Information

  • NPI: 1114988995
  • Provider Name: DR. WALLACE HAROLD BROWN, M.D.
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Individual
  • Address: 2210 LINE AVE
    SUITE 204
    SHREVEPORT, LA
    ZIP 71104
  • Phone: (318) 221-9671

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NPI Details

DR. Wallace Harold Brown, M.D. is a plastic surgery in Shreveport, LA. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. DR. Wallace Harold Brown, M.D. NPI is 1114988995. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2210 LINE AVE
SUITE 204
SHREVEPORT, LA
ZIP 71104-152
Phone: (318) 221-9671
Fax: (318) 425-2343

The enumeration date for this NPI number is 3/31/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery011630LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11385344MEDICAIDLOUISIANA
2D79341MEDICARE UPINLOUISIANA
35J441B255MEDICARE ID-TYPE UNSPECIFIEDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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