Healthcare Provider Details

I. General information

NPI: 1023376498
Provider Name (Legal Business Name): LSU HEALTHCARE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 CHESTNUT ST 3RD FLOOR
NEW ORLEANS LA
70115-2443
US

IV. Provider business mailing address

1340 POYDRAS ST SUITE 1640
NEW ORLEANS LA
70112-1221
US

V. Phone/Fax

Practice location:
  • Phone: 504-412-1580
  • Fax: 504-412-1530
Mailing address:
  • Phone: 504-412-1100
  • Fax: 504-412-1530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: SUSAN GOULD
Title or Position: ADMINISTRATIVE ASSISTANT III
Credential:
Phone: 504-903-9213