Healthcare Provider Details

I. General information

NPI: 1598826885
Provider Name (Legal Business Name): ERIC R GEORGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4228 HOUMA BLVD SUITE 600B
METAIRIE LA
70006
US

IV. Provider business mailing address

4228 HOUMA BLVD SUITE 600B
METAIRIE LA
70006
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-2191
  • Fax: 504-454-3106
Mailing address:
  • Phone: 504-454-2191
  • Fax: 504-454-3106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number11227R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: