Basic Information
| Provider Information | |||||||||
| NPI: | 1124166202 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TUHC ANESTHESIOLOGY GROUP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 I-10 SERVICE ROAD | ||||||||
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| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5047808282 | ||||||||
| FaxNumber: | 5049881743 | ||||||||
| Practice Location | |||||||||
| Address1: | 4700 I-10 SERVICE ROAD | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5047808282 | ||||||||
| FaxNumber: | 5049881743 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 06/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | LAGESSE | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5049887404 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNIVERSITY HEALTHCARE SYSTEM, LC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1449474 | 05 | LA | MEDICAID |