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General NPI Number Information
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NPI Number | 1639506918
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Entity Type | Organization
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Legal Business Name | PARISH ANESTHESIA EJ ASC LLC
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 4320 HOUMA BLVD FL 5
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City | METAIRIE
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State | LA
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Zip | 70006-2961
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Country | US
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Telephone | 504-779-5515
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Fax |
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Provider Business Mailing Address
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Address Line | 3510 N CAUSEWAY BLVD STE 404
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City | METAIRIE
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State | LA
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Zip | 70002-3531
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Country | US
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Telephone | 504-779-5515
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TONY STEVEN MARTIN
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Credential |
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Telephone | 504-779-5515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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