Healthcare Provider Details

I. General information

NPI: 1184706913
Provider Name (Legal Business Name): CLIFTON SCOTT NICHOLSON-UHL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MEDICAL CENTER BLVD SUITE 250S
MARRERO LA
70072-3151
US

IV. Provider business mailing address

26 CASTLE PINES DR
NEW ORLEANS LA
70131-3326
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-6945
  • Fax: 504-349-6949
Mailing address:
  • Phone: 504-349-6945
  • Fax: 504-349-6949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD.021994
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: