Healthcare Provider Details

I. General information

NPI: 1568483584
Provider Name (Legal Business Name): ALAN BLAND MARR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 10/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 PERDIDO ST
NEW ORLEANS LA
70112-1352
US

IV. Provider business mailing address

1340 POYDRAS ST
NEW ORLEANS LA
70112-1221
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-2315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number08598R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number08598R
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number08598R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: