Healthcare Provider Details

I. General information

NPI: 1780131490
Provider Name (Legal Business Name): HAMMOND ANESTHESIA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2016
Last Update Date: 09/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42131 VETERANS AVE STE 200
HAMMOND LA
70403-1428
US

IV. Provider business mailing address

42131 VETERANS AVE STE 200
HAMMOND LA
70403-1428
US

V. Phone/Fax

Practice location:
  • Phone: 985-345-7246
  • Fax: 985-345-7249
Mailing address:
  • Phone: 985-345-7246
  • Fax: 985-345-7249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF PARKS
Title or Position: VP
Credential:
Phone: 813-569-6500