1144249319 NPI number — DR. TIN TIN SWE DEVOE M.D.

Table of content: DR. TIN TIN SWE DEVOE M.D. (NPI 1144249319)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144249319 NPI number — DR. TIN TIN SWE DEVOE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEVOE
Provider First Name:
TIN TIN
Provider Middle Name:
SWE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1144249319
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4880 HIGHWAY 22
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANDEVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70471-6748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-845-4082
Provider Business Mailing Address Fax Number:
985-845-1969

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4880 HIGHWAY 22
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANDEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70471-6748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-845-8894
Provider Business Practice Location Address Fax Number:
985-845-1969
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  016922 , 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: 0678432 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1326551 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 174540401769 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1200111 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 85720 . This is a "COVENTRY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4254173 . This is a "AETNA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1447048 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 26652840A . This is a "BLUE CROSS FEDERAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 53252 . This is a "BLUE CROSS" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 85920 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".




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