Healthcare Provider Details
I. General information
NPI: 1013911569
Provider Name (Legal Business Name): RICHARD DOSKEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9605 JEFFERSON HWY
RIVER RIDGE LA
70123-2550
US
IV. Provider business mailing address
298 HENRY CLAY AVE
NEW ORLEANS LA
70118-5720
US
V. Phone/Fax
- Phone: 504-738-1604
- Fax: 504-738-7860
- Phone: 504-896-9827
- Fax: 504-894-5370
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 018192 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: