MEDICARE: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY G

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	207L00000X	Anesthesiology Physician		LA

General Provider Information

NPI Number	:	1437108297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY G

Provider Business Mailing Address
First Line	:	478 S JOHNSON ST FL 6
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 W ESPLANADE AVE
Second Line	:	ANESTHESIA DEPT.
City	:	KENNER
State	:	LA
Zip	:	70065-2467
Country	:	US
Telephone Number	:	504-468-8600
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	ATARA MCAVOY
Credential	:
Telephone Number	:	504-412-1819

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	12/04/2024

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