=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952608820
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OCHSNER CLINIC LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2011
-----------------------------------------------------
Last Update Date | 02/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 JUDGE TANNER BLVD SUITE 301
-----------------------------------------------------
City | COVINGTON
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70433-7503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-809-5850
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 54851
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70154-4851
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-842-3000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | MR. SCOTT J POSECAI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 504-842-4000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------