Healthcare Provider Details

I. General information

NPI: 1689763302
Provider Name (Legal Business Name): STEPHEN JOSEPH DERBES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 PRYTANIA ST #321
NEW ORLEANS LA
70115
US

IV. Provider business mailing address

3525 PRYTANIA ST #321
NEW ORLEANS LA
70115
US

V. Phone/Fax

Practice location:
  • Phone: 504-891-1211
  • Fax: 504-897-8702
Mailing address:
  • Phone: 504-891-1211
  • Fax: 504-897-8702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number010617
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number010617
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: