Basic Information
Provider Information
NPI: 1023066107
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FUSELIER
FirstName: HAROLD
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1340 POYDRAS ST
Address2: SUITE 1640
City: NEW ORLEANS
State: LA
PostalCode: 701121221
CountryCode: US
TelephoneNumber: 5044121835
FaxNumber: 5044121954
Practice Location
Address1: 2820 NAPOLEON AVE
Address2: SUITE 890
City: NEW ORLEANS
State: LA
PostalCode: 701156969
CountryCode: US
TelephoneNumber: 5044121366
FaxNumber: 5044121367
Other Information
ProviderEnumerationDate: 05/04/2006
LastUpdateDate: 02/16/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208800000XMD.010551LAY Allopathic & Osteopathic PhysiciansUrology 

ID Information
IDTypeStateIssuerDescription
0001227205MS MEDICAID
113853305LA MEDICAID


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