| |
1415 Tulane Ave Hc71 New Orleans LA 70112-2600 | |
(504) 988-5881 | |
(866) 403-1780 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1415 Tulane Ave, New Orleans, Louisiana |
Authorized Official Name and Position | Ashley H Mcgaha (CFO) |
Authorized Official Contact | 5049886849 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1415 Tulane Ave Hc71 New Orleans LA 70112-2600 Ph: (504) 988-5881 | 1415 Tulane Ave Hc71 New Orleans LA 70112-2600 Ph: (504) 988-5881 |
NPI Number | 1942256383 |
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Provider Enumeration Date | 05/26/2006 |
Last Update Date | 12/29/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942256383 | NPI | - | NPPES |
1444910 | Other | LA | MEDICAID COMMUNITY CARE |
1944386 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
208600000X | Surgery | (* (Not Available)) | Secondary |
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