Healthcare Provider Details
I. General information
NPI: 1902367360
Provider Name (Legal Business Name): OCHSNER CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/28/2019
Last Update Date: 04/20/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1532 ALLEN TOUSSAINT BLVD
NEW ORLEANS LA
70122-2146
US
IV. Provider business mailing address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
V. Phone/Fax
- Phone: 504-842-9646
- Fax:
- Phone: 504-842-4000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDUARDO
BENITEZ
Title or Position: DIRECTOR
Credential:
Phone: 504-842-6933