Healthcare Provider Details

I. General information

NPI: 1962769141
Provider Name (Legal Business Name): CARLOS ALBERTO HARTMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CARLOS ALBERTO HARTMANN MANRIQUE MD

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OCHSNER BLVD
COVINGTON LA
70433-8107
US

IV. Provider business mailing address

PO BOX 1289
MANDEVILLE LA
70470-1289
US

V. Phone/Fax

Practice location:
  • Phone: 985-875-2828
  • Fax: 985-898-7492
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number50301
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number321755
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: