Healthcare Provider Details

I. General information

NPI: 1790354595
Provider Name (Legal Business Name): ADMINISTRATORS OF THE TULANE EDUCATION FUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CANAL ST
NEW ORLEANS LA
70112-3018
US

IV. Provider business mailing address

PO BOX 669377
DALLAS TX
75266-9377
US

V. Phone/Fax

Practice location:
  • Phone: 504-702-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DELONDER JOHNSON
Title or Position: MANAGER
Credential:
Phone: 504-988-1508