Healthcare Provider Details

I. General information

NPI: 1790296762
Provider Name (Legal Business Name): BONE & JOINT CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 BELLE CHASSE HWY STE I
TERRYTOWN LA
70056-7156
US

IV. Provider business mailing address

2600 BELLE CHASSE HWY STE I
TERRYTOWN LA
70056-7156
US

V. Phone/Fax

Practice location:
  • Phone: 504-391-7670
  • Fax: 504-378-9439
Mailing address:
  • Phone: 504-391-7670
  • Fax: 504-378-9439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL J GALLAGHER
Title or Position: M.D.
Credential: M.D.
Phone: 504-391-7670