Healthcare Provider Details

I. General information

NPI: 1134043755
Provider Name (Legal Business Name): LAMARTINA MED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 GIROD ST
MANDEVILLE LA
70448-5811
US

IV. Provider business mailing address

220 GIROD ST
MANDEVILLE LA
70448-5811
US

V. Phone/Fax

Practice location:
  • Phone: 985-317-9563
  • Fax:
Mailing address:
  • Phone: 985-317-9563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN LAMARTINA
Title or Position: MD
Credential: MD
Phone: 985-317-9563