| Louisiana Avenue Medical Center Inc | |
|
4301 Elysian Fields Avenue New Orleans LA 70122-7404 | |
| (504) 284-3866 | |
| (504) 284-3869 |
| Full Name | Louisiana Avenue Medical Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4301 Elysian Fields Avenue, New Orleans, Louisiana |
| Authorized Official Name and Position | Henry M Evans (PRESIDENT / MEDICAL DIRECTOR) |
| Authorized Official Contact | 5042843866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Avenue Medical Center Inc 4301 Elysian Fields Avenue New Orleans LA 70122-7404 Ph: (504) 284-3866 | Louisiana Avenue Medical Center Inc 4301 Elysian Fields Avenue New Orleans LA 70122-7404 Ph: (504) 284-3866 |
| NPI Number | 1184664534 |
|---|---|
| Provider Enumeration Date | 06/07/2006 |
| Last Update Date | 09/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184664534 | NPI | - | NPPES |
| 1942421 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 012410 (Louisiana) | Primary |
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