Healthcare Provider Details

I. General information

NPI: 1992580252
Provider Name (Legal Business Name): RCNO SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 S I 10 SERVICE RD W STE 204
METAIRIE LA
70001-6418
US

IV. Provider business mailing address

3636 S I 10 SERVICE RD W STE 204
METAIRIE LA
70001-6418
US

V. Phone/Fax

Practice location:
  • Phone: 504-218-4936
  • Fax:
Mailing address:
  • Phone: 504-218-4936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN GUIDRY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 504-218-4936