Basic Information
| Provider Information | |||||||||
| NPI: | 1669653887 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEMATOLOGY & ONCOLOGY SPECIALISTS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 54932 | ||||||||
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| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5046799901 | ||||||||
| FaxNumber: | 5046799928 | ||||||||
| Practice Location | |||||||||
| Address1: | 39 STARBRUSH CIR | ||||||||
| Address2: | |||||||||
| City: | COVINGTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704337209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9858929090 | ||||||||
| FaxNumber: | 9858929957 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2007 | ||||||||
| LastUpdateDate: | 05/23/2008 | ||||||||
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| AuthorizedOfficialLastName: | SAUX | ||||||||
| AuthorizedOfficialFirstName: | JACK | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5046799901 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HEMATOLOGY & ONCOLOGY SPECIALISTS LLC | ||||||||
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| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.