Healthcare Provider Details

I. General information

NPI: 1811154875
Provider Name (Legal Business Name): TUHC COMMUNITY CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1415 TULANE AVE ENROLLMENT DEPARTMENT, ROOM 6812
NEW ORLEANS LA
70112-2600
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-3290
  • Fax: 504-988-6216
Mailing address:
  • Phone: 504-988-3290
  • Fax: 504-988-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateLA

VIII. Authorized Official

Name: MR. ROBERT LAGESSE
Title or Position: VP
Credential:
Phone: 504-988-7044