Basic Information
| Provider Information | |||||||||
| NPI: | 1447487145 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LSUHSC NEW ORLEANS PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 433 BOLIVAR ST | ||||||||
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| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701122256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045684808 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 HENRY CLAY AVE | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701185720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048999511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2009 | ||||||||
| LastUpdateDate: | 07/30/2009 | ||||||||
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| AuthorizedOfficialLastName: | LANDRY | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 5045684815 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.