Healthcare Provider Details

I. General information

NPI: 1235329723
Provider Name (Legal Business Name): JEFFREY ROBERT SPRINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 PERDIDO ST
NEW ORLEANS LA
70112-1393
US

IV. Provider business mailing address

4211 SPRINGBOURNE WAY APT 205
LOUISVILLE KY
40241-5159
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-6031
  • Fax:
Mailing address:
  • Phone: 484-357-9901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberPGY.3.LSUN-PATH
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: