Healthcare Provider Details

I. General information

NPI: 1356620249
Provider Name (Legal Business Name): PARISH ANESTHESIA GASTROENTEROLOGY OF TULANE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2011
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE 3RD FLOOR
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

3510 N. CAUSEWAY BLVD SUITE 404
METAIRIE LA
70002-3531
US

V. Phone/Fax

Practice location:
  • Phone: 504-779-5515
  • Fax:
Mailing address:
  • Phone: 504-779-5515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: TONY STEVEN MARTIN
Title or Position: PRESIDENT
Credential:
Phone: 504-779-5515