Healthcare Provider Details

I. General information

NPI: 1609307578
Provider Name (Legal Business Name): KODY ANDREW BLISS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NAPOLEON AVE FL 2
NEW ORLEANS LA
70115-6948
US

IV. Provider business mailing address

2801 NAPOLEON AVE FL 2
NEW ORLEANS LA
70115-6948
US

V. Phone/Fax

Practice location:
  • Phone: 504-323-6334
  • Fax: 504-323-6335
Mailing address:
  • Phone: 504-323-6334
  • Fax: 504-323-6335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number309351
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: