Healthcare Provider Details

I. General information

NPI: 1215515473
Provider Name (Legal Business Name): BRADEN GEORGE THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401A JEFFERSON HWY
NEW ORLEANS LA
70121-2426
US

IV. Provider business mailing address

1401A JEFFERSON HWY
NEW ORLEANS LA
70121-2426
US

V. Phone/Fax

Practice location:
  • Phone: 866-624-7637
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberD0100499
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number351534
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: