Healthcare Provider Details

I. General information

NPI: 1811929292
Provider Name (Legal Business Name): YVETTE SUSI FOLSE M.D.,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 FOUCHER ST # &RM-1005
NEW ORLEANS LA
70115-3515
US

IV. Provider business mailing address

3600 PRYTANIA ST STE 35
NEW ORLEANS LA
70115-3678
US

V. Phone/Fax

Practice location:
  • Phone: 504-897-8543
  • Fax:
Mailing address:
  • Phone: 504-897-8412
  • Fax: 504-249-5311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number16722
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD.023085
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: