Healthcare Provider Details

I. General information

NPI: 1265078877
Provider Name (Legal Business Name): OCHSNER CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14601 AIRLINE HWY STE 103
GONZALES LA
70737-6658
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 225-236-5970
  • Fax: 225-236-5971
Mailing address:
  • Phone: 504-842-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO BENITEZ
Title or Position: DIRECTOR
Credential:
Phone: 504-842-6933