Healthcare Provider Details
I. General information
NPI: 1346445459
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2007
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
39 STARBRUSH CIR
COVINGTON LA
70433-7209
US
IV. Provider business mailing address
PO BOX 54932
NEW ORLEANS LA
70154
US
V. Phone/Fax
- Phone: 985-892-9090
- Fax: 504-892-9957
- Phone: 504-679-9901
- Fax: 504-679-9928
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JACK
E
SAUX
III
Title or Position: PRESIDENT
Credential: MD
Phone: 504-679-9901