Healthcare Provider Details

I. General information

NPI: 1942591458
Provider Name (Legal Business Name): JOSEPH ANDREW MATHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 HOUMA BLVD STE 300
METAIRIE LA
70006-4310
US

IV. Provider business mailing address

3601 HOUMA BLVD STE 300
METAIRIE LA
70006-4310
US

V. Phone/Fax

Practice location:
  • Phone: 504-885-7360
  • Fax: 504-885-1360
Mailing address:
  • Phone: 504-885-7360
  • Fax: 504-885-1360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.205907
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: