Healthcare Provider Details

I. General information

NPI: 1902060270
Provider Name (Legal Business Name): OCHSNER BAYOU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4608 HIGHWAY 1
RACELAND LA
70394-2623
US

IV. Provider business mailing address

4608 HIGHWAY 1
RACELAND LA
70394-2623
US

V. Phone/Fax

Practice location:
  • Phone: 985-537-6841
  • Fax:
Mailing address:
  • Phone: 985-537-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number594
License Number StateLA

VIII. Authorized Official

Name: MR. FERNIS LEBLANC
Title or Position: CEO
Credential:
Phone: 985-537-2684