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General NPI Number Information
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NPI Number | 1659551414
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Entity Type | Organization
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Legal Business Name | BERNARD A LANDRY, MD, LLC
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 07/05/2011
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Provider Practice Location Address
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Address Line | 3434 HOUMA BLVD STE 300A
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City | METAIRIE
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State | LA
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Zip | 70006-4200
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Country | US
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Telephone | 504-454-9496
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Fax |
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Provider Business Mailing Address
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Address Line | 19 KILLDEER ST
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City | NEW ORLEANS
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State | LA
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Zip | 70124-4512
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Country | US
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Telephone | 504-722-5500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BERNARD ALDRICH LANDRY
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Credential | MD
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Telephone | 504-615-0799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD-018244
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License Number State | LA
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