1437108297 NPI number — LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY G

Table of content: (NPI 1437108297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437108297 NPI number — LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY G

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY G
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEW ORLEANS LSU ANESTHESIA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437108297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 62600
Provider Second Line Business Mailing Address:
DEPT. 1362
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70162-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-834-2062
Provider Business Mailing Address Fax Number:
504-831-7429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 W ESPLANADE AVE
Provider Second Line Business Practice Location Address:
ANESTHESIA DEPT.
Provider Business Practice Location Address City Name:
KENNER
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70065-2467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-468-8600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
OLDS
Authorized Official First Name:
JANE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OPERATING OFFICER
Authorized Official Telephone Number:
504-568-4009

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07322221 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1447871 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05252078 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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