Basic Information
| Provider Information | |||||||||
| NPI: | 1639506918 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARISH ANESTHESIA EJ ASC LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3510 N CAUSEWAY BLVD | ||||||||
| Address2: | STE 404 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700023531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5047795515 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4320 HOUMA BLVD FL 5 | ||||||||
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| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700062961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5047795515 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2013 | ||||||||
| LastUpdateDate: | 10/02/2013 | ||||||||
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| AuthorizedOfficialLastName: | MARTIN | ||||||||
| AuthorizedOfficialFirstName: | TONY | ||||||||
| AuthorizedOfficialMiddleName: | STEVEN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5047795515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.