Healthcare Provider Details

I. General information

NPI: 1912148909
Provider Name (Legal Business Name): JAMIE M. SIAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BIENVILLE ST UNIT B
NEW ORLEANS LA
70119-5163
US

IV. Provider business mailing address

3600 PRYTANIA ST STE 35
NEW ORLEANS LA
70115-3628
US

V. Phone/Fax

Practice location:
  • Phone: 504-252-9488
  • Fax: 504-302-2571
Mailing address:
  • Phone: 504-897-8315
  • Fax: 504-891-9862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD.206249
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: