Healthcare Provider Details

I. General information

NPI: 1588082226
Provider Name (Legal Business Name): ALEXANDER SCOTT WHITEHEAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

IV. Provider business mailing address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

V. Phone/Fax

Practice location:
  • Phone: 504-468-8600
  • Fax:
Mailing address:
  • Phone: 504-468-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number305172
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: