Healthcare Provider Details

I. General information

NPI: 1114066842
Provider Name (Legal Business Name): PATRICK DELERY DRENNAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 STATE ST
NEW ORLEANS LA
70118-5735
US

IV. Provider business mailing address

1302 JACKSON AVE
NEW ORLEANS LA
70130-5132
US

V. Phone/Fax

Practice location:
  • Phone: 504-897-4741
  • Fax: 504-896-4918
Mailing address:
  • Phone: 504-523-3603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number025246
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: