Healthcare Provider Details

I. General information

NPI: 1386020246
Provider Name (Legal Business Name): RAY WORTHY PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 RIVER OAKS RD W
NEW ORLEANS LA
70123-2162
US

IV. Provider business mailing address

1525 RIVER OAKS RD W
NEW ORLEANS LA
70123-2162
US

V. Phone/Fax

Practice location:
  • Phone: 505-734-1740
  • Fax: 985-781-4319
Mailing address:
  • Phone: 505-734-1740
  • Fax: 985-781-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number205358
License Number StateLA

VIII. Authorized Official

Name: DR. RAY B WORTHY
Title or Position: OWNER
Credential: MD
Phone: 985-781-0548