1740498880 NPI number — MRS. WENDY GRIM DONEYHUE M.D.

Table of content: KALI MARIE HOUSTON (NPI 1285408567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740498880 NPI number — MRS. WENDY GRIM DONEYHUE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONEYHUE
Provider First Name:
WENDY
Provider Middle Name:
GRIM
Provider Name Prefix Text:
MRS.
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:
1740498880
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 W SAINT CLAIR ST
Provider Second Line Business Mailing Address:
RM 1A
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16365-2187
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-842-4000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 OCHSNER BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-639-3777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2007

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: 207W00000X , with the licence number:  MD.201421 , 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: 1508101 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 09357021 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com