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General NPI Number Information
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NPI Number | 1710286794
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Entity Type | Organization
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Legal Business Name | PONTCHARTRAIN CANCER CENTER
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 120 LAKEVIEW CIR
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City | COVINGTON
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State | LA
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Zip | 70433-7512
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Country | US
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Telephone | 985-875-1202
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Fax | 985-875-1205
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Provider Business Mailing Address
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Address Line | 15752 MEDICAL ARTS PLAZA SUITE 101
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City | HAMMOND
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State | LA
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Zip | 70403-1446
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Country | US
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Telephone | 985-419-0025
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Fax | 985-875-0035
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Authorized Official
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Title or Position | M.D.,/ OWNER
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Name | DR. DAVID NELSON OUBRE
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Credential | M.D.,
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Telephone | 985-419-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 203749
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | RN083847-AP04197
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 22330
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License Number State | LA
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