Healthcare Provider Details

I. General information

NPI: 1811910862
Provider Name (Legal Business Name): ARTURO DAVID GONZALEZ-ROMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF RADIOLOGY 1542 TULANE AVE, BOX T2-2
NEW ORLEANS LA
70112
US

IV. Provider business mailing address

2390 W CONGRESS ST UNIVERSITY HOSPITAL & CLINICS, INTERVENTIONAL RADIOLOGY
LAFAYETTE LA
70506-4205
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-4646
  • Fax:
Mailing address:
  • Phone: 337-261-6000
  • Fax: 337-261-6153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD.13104R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: