Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary T Kim, MD

Individual provider Plastic and Reconstructive Surgery Physician · NPI 1033192828

Mary T Kim, MD is a Plastic and Reconstructive Surgery in Shreveport, Louisiana. Graduated from Tufts University School of Medicine in 1997, 29 years ago. Practices with Bundrick and O'Neal Plastic Surgery (Amc), a 3-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
29
Trained at
Tufts University School of Medicine
Licensed in
LA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1501 Kings Hwy
Shreveport, LA 71103-4228
Phone: (318) 675-6154
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X · Licence MD200563 (LA)

Record details

NPI number1033192828
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 25, 2005
Last updated in NPPESMay 18, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolTUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1997 (29 years in practice)
Group practice Bundrick And O'Neal Plastic Surgery (Amc) — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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