MEDICARE: DR. KATHLEEN ELIZABETH WALSH M.D.

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	208800000X	Urology Physician	015861	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	015861	OTHER	LA	STATE LICENSING NUMBER
2	11451	OTHER	LA	STATE NARCOTICS LICENSING NUMBER

General Provider Information

NPI Number	:	1932375995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHLEEN ELIZABETH WALSH M.D.

Provider Business Mailing Address
First Line	:	1310 HENRY CLAY AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-6009
Country	:	US
Telephone Number	:	504-451-0609
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 HENRY CLAY AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-6009
Country	:	US
Telephone Number	:	504-451-0609
Fax Number	:	504-891-5095

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

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	03/07/2023

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