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General NPI Number Information
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NPI Number | 1043513401
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Entity Type | Organization
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Legal Business Name | DELTA SOUTH ANESTHESIA AND PAIN
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 3017 GALLERIA DR
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City | METAIRIE
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State | LA
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Zip | 70001-2009
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Country | US
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Telephone | 504-232-0213
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Fax |
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Provider Business Mailing Address
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Address Line | 535 ARLINGTON DR
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City | METAIRIE
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State | LA
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Zip | 70001-5515
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Country | US
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Telephone | 504-232-0213
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM EATON
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Credential | M.D.
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Telephone | 504-232-0213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | LA
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