Basic Information
| Provider Information | |||||||||
| NPI: | 1235368937 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEADACHE CENTER OF NEW ORLEANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 S EXECUTIVE DR | ||||||||
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| City: | BROOKFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530054257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2627874026 | ||||||||
| FaxNumber: | 2627826040 | ||||||||
| Practice Location | |||||||||
| Address1: | 2905 KINGMAN ST | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700066615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048853737 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2009 | ||||||||
| LastUpdateDate: | 07/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | VOIGT | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2627874026 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MD201694 | LA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.