Basic Information
| Provider Information | |||||||||
| NPI: | 1689722340 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CRESCENT CITY PHYSICIANS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 PRYTANIA ST | ||||||||
| Address2: | SUITE 35 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153672 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978315 | ||||||||
| FaxNumber: | 5048919862 | ||||||||
| Practice Location | |||||||||
| Address1: | 3600 PRYTANIA ST | ||||||||
| Address2: | SUITE 35 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153672 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978315 | ||||||||
| FaxNumber: | 5048919862 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 05/20/2014 | ||||||||
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| AuthorizedOfficialLastName: | KRANE | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIR OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 5048977794 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207V00000X | LA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 208800000X | LA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology | 2085R0001X | LA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 208600000X | LA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 208G00000X | LA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 207Q00000X | LA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1943479 | 05 | LA | MEDICAID |