| |
5300 Tchoupitoulas St New Orleans LA 70115-1936 | |
(504) 703-3070 | |
(504) 703-3071 |
Full Name | |
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Speciality | Internal Medicine |
Location | 5300 Tchoupitoulas St, New Orleans, Louisiana |
Authorized Official Name and Position | Vinson Prescott Smith (DIRECTOR) |
Authorized Official Contact | 5048420371 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1514 Jefferson Hwy New Orleans LA 70121-2429 Ph: (504) 842-4000 | 5300 Tchoupitoulas St New Orleans LA 70115-1936 Ph: (504) 703-3070 |
NPI Number | 1033602891 |
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Provider Enumeration Date | 06/07/2018 |
Last Update Date | 06/07/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033602891 | NPI | - | NPPES |
1030228 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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