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NPI 1275984973

NPI 1275984973 : LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY : NEW ORLEANS, LA

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General NPI Number Information
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    NPI Number           |    1275984973
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    Entity Type          |    Organization 
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    Legal Business Name  |    LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS FACULTY 
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Dates
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    Enumeration Date     |    06/24/2016
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    Last Update Date     |    12/04/2024
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Provider Practice Location Address
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    Address Line         |    2000 CANAL ST 
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    City                 |    NEW ORLEANS
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    State                |    LA
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    Zip                  |    70112-3018
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    Country              |    US
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    Telephone            |    504-702-3000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    478 S JOHNSON ST FL 6 
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    City                 |    NEW ORLEANS
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    State                |    LA
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    Zip                  |    70112-2238
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CHIEF FINANCIAL OFFICER
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    Name                 |     ATARA  MCAVOY 
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    Credential           |    
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    Telephone            |    504-412-1819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    
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    License Number State |    
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