Basic Information
| Provider Information | |||||||||
| NPI: | 1881773802 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAYNE S GURTLER MD LAURA A BRINZ MD AND JANET BURROFF | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3939 HOUMA BLVD | ||||||||
| Address2: | STE 6 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700062931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048850577 | ||||||||
| FaxNumber: | 5048887441 | ||||||||
| Practice Location | |||||||||
| Address1: | 3939 HOUMA BLVD | ||||||||
| Address2: | STE 6 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700062931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048850577 | ||||||||
| FaxNumber: | 5048881308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 07/25/2016 | ||||||||
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| AuthorizedOfficialLastName: | GURTLER | ||||||||
| AuthorizedOfficialFirstName: | JAYNE | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5048850577 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.