Healthcare Provider Details

I. General information

NPI: 1730368937
Provider Name (Legal Business Name): JAMIE ELLIS-JOHN HUTCHINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 WESTBANK EXPY
MARRERO LA
70072-2954
US

IV. Provider business mailing address

5001 WESTBANK EXPY
MARRERO LA
70072-2954
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-8833
  • Fax:
Mailing address:
  • Phone: 504-349-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD.202755
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: