Healthcare Provider Details

I. General information

NPI: 1336147008
Provider Name (Legal Business Name): JULES S DEUTSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MEDICAL CENTER BLVD SUITE 313N
MARRERO LA
70072-3151
US

IV. Provider business mailing address

1111 MEDICAL CENTER BLVD SUITE 313N
MARRERO LA
70072-3151
US

V. Phone/Fax

Practice location:
  • Phone: 504-371-0071
  • Fax: 504-371-0272
Mailing address:
  • Phone: 504-371-0071
  • Fax: 504-371-0272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number010124
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: