MEDICARE: SOUTHERN NEUROINTERVENTIONAL INSTITUTE

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	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1467193300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN NEUROINTERVENTIONAL INSTITUTE

Provider Business Mailing Address
First Line	:	120 N CATE ST
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-3357
Country	:	US
Telephone Number	:	985-507-5259
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 N CATE ST
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-3357
Country	:	US
Telephone Number	:	985-507-5259
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ZACHARY JEFFERSON LINER
Credential	:	MD
Telephone Number	:	985-507-5259

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	09/11/2025

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