Basic Information
| Provider Information | |||||||||
| NPI: | 1760687230 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEMATOLOGY & 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: | 506 RUE DE SANTE | ||||||||
| Address2: | |||||||||
| City: | LA PLACE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700685418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9856516972 | ||||||||
| FaxNumber: | 9856512056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2007 | ||||||||
| LastUpdateDate: | 06/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | SAUX | ||||||||
| AuthorizedOfficialFirstName: | JACK | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5046799901 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HEMATOLOGY AND 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 | 207RH0003X | LA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.