MEDICARE: OCHSNER MISSISSIPPI, LLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1588385561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCHSNER MISSISSIPPI, LLC

Provider Business Mailing Address
First Line	:	1514 JEFFERSON HWY
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70121-2429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3068 PORT AND HARBOR DR
Second Line	:
City	:	BAY SAINT LOUIS
State	:	MS
Zip	:	39520-9306
Country	:	US
Telephone Number	:	228-533-9000
Fax Number	:	228-395-1290

Authorized Official
Title or Position	:	DIRECTOR
Name	:	EDUARDO BENITEZ
Credential	:
Telephone Number	:	504-430-0025

Provider Enumeration Date	:	09/07/2022
Last Update Date	:	09/07/2022

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