MEDICARE: DR. STEVEN R DELOACH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	025091	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235125733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN R DELOACH MD

Provider Business Mailing Address
First Line	:	1224 SAINT CHARLES AVE
Second Line	:	1-C
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4334
Country	:	US
Telephone Number	:	504-301-1670
Fax Number	:

Provider Business Practice Location Address
First Line	:	1224 SAINT CHARLES AVE
Second Line	:	1-C
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4334
Country	:	US
Telephone Number	:	504-301-1670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	09/17/2014

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