Healthcare Provider Details

I. General information

NPI: 1164411161
Provider Name (Legal Business Name): JESSICA COLLER OCHSNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: J COLLER OCHSNER MD

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 METAIRIE RD
METAIRIE LA
70001-5561
US

IV. Provider business mailing address

2323 METAIRIE RD
METAIRIE LA
70001-5561
US

V. Phone/Fax

Practice location:
  • Phone: 504-831-6633
  • Fax: 504-831-6654
Mailing address:
  • Phone: 504-831-6633
  • Fax: 504-831-6654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMD015824
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD015824
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: