MEDICARE: CONNOR MARK CHAMBERLAIN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	344077	LA

General Provider Information

NPI Number	:	1144088956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNOR MARK CHAMBERLAIN PA

Provider Business Mailing Address
First Line	:	3434 HOUMA BLVD STE 301
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006-4201
Country	:	US
Telephone Number	:	504-754-2334
Fax Number	:

Provider Business Practice Location Address
First Line	:	3434 HOUMA BLVD STE 301
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006-4201
Country	:	US
Telephone Number	:	504-754-2334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2024
Last Update Date	:	05/29/2026

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Directions to “ CONNOR MARK CHAMBERLAIN PA” Practice Location

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