MEDICARE: DOCTORS CHOICE INC.

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1174765499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS CHOICE INC.

Provider Business Mailing Address
First Line	:	201 SAINT CHARLES AVE STE 114
Second Line	:	SUITE 278
City	:	NEW ORLEANS
State	:	LA
Zip	:	70170-0114
Country	:	US
Telephone Number	:	504-552-2794
Fax Number	:	504-552-2794

Provider Business Practice Location Address
First Line	:	201 SAINT CHARLES AVE STE 114
Second Line	:	SUITE 278
City	:	NEW ORLEANS
State	:	LA
Zip	:	70170-0114
Country	:	US
Telephone Number	:	504-552-2794
Fax Number	:	504-552-2794

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIO A ACOSTA
Credential	:
Telephone Number	:	504-552-2794

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	04/01/2009

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Directions to “DOCTORS CHOICE INC. ” Practice Location

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