Healthcare Provider Details

I. General information

NPI: 1215810189
Provider Name (Legal Business Name): NEW ORLEANS PHYSICIAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4945 LAPALCO BLVD STE 200
MARRERO LA
70072-4313
US

IV. Provider business mailing address

1100 POYDRAS ST
NEW ORLEANS LA
70163-1101
US

V. Phone/Fax

Practice location:
  • Phone: 504-301-2825
  • Fax:
Mailing address:
  • Phone: 504-527-9953
  • Fax: 504-527-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KANDACE MATHERNE
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 504-527-9953