Healthcare Provider Details

I. General information

NPI: 1073689667
Provider Name (Legal Business Name): LOUISIANA DEPARTMENT OF HEALTH - OFFICE OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 POYDRAS ST STE 1945
NEW ORLEANS LA
70112-1227
US

IV. Provider business mailing address

PO BOX 61979
NEW ORLEANS LA
70161-1979
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-3420
  • Fax: 504-568-8200
Mailing address:
  • Phone: 504-568-2600
  • Fax: 504-568-8200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateLA

VIII. Authorized Official

Name: DOROTHY SUE CROTWELL
Title or Position: PROGRAM MANAGER
Credential:
Phone: 504-568-3420