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General NPI Number Information
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NPI Number | 1861934747
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Entity Type | Organization
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Legal Business Name | HAIR RESTORATION OF THE SOUTH LLC
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 06/27/2020
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Provider Practice Location Address
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Address Line | 3100 GALLERIA DRIVE STE 201
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City | METAIRIE
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State | LA
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Zip | 70001
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Country | US
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Telephone | 504-301-4247
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 GALLERIA DRIVE STE 201
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City | METAIRIE
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State | LA
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Zip | 70001
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Country | US
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Telephone | 504-315-4247
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | DR. NICOLE ELAINE ROGERS
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Credential | MD
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Telephone | 504-315-4247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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