Healthcare Provider Details

I. General information

NPI: 1710512025
Provider Name (Legal Business Name): ALEXIS MCCARTHY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXIS HEPTING PA-C

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-4070
  • Fax: 504-842-0224
Mailing address:
  • Phone: 504-842-4070
  • Fax: 504-842-0224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number323266
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: