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General NPI Number Information
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NPI Number | 1902858830
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Entity Type | Organization
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Legal Business Name | NICHOLSON BAEHR CALHOUN MDS LTD APMC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 829 BARATARIA BLVD
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City | MARRERO
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State | LA
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Zip | 70072-1839
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Country | US
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Telephone | 504-347-4537
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Fax | 504-341-8425
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Provider Business Mailing Address
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Address Line | 829 BARATARIA BLVD
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City | MARRERO
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State | LA
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Zip | 70072-1839
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Country | US
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Telephone | 504-347-4537
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Fax | 504-341-8425
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Authorized Official
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Title or Position | VP
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Name | JEFF HENDERSON
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Credential |
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Telephone | 225-753-0887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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