MEDICARE: CHILDRENS CLINIC OF NEW ORLEANS

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	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538381546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDRENS CLINIC OF NEW ORLEANS

Provider Business Mailing Address
First Line	:	3201 GENERAL MEYER AVE
Second Line	:	SUITE C
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-3204
Country	:	US
Telephone Number	:	504-362-8930
Fax Number	:	504-362-8486

Provider Business Practice Location Address
First Line	:	3201 GENERAL MEYER AVE
Second Line	:	SUITE C
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-3204
Country	:	US
Telephone Number	:	504-362-8930
Fax Number	:	504-362-8486

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. THATTIL PAVUNNY GOURI
Credential	:	M.D.
Telephone Number	:	504-362-8930

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1346221660 — JUDITH HERTANU MD
Practice Location Address:

10 UNION SQ E , BETH ISRAEL MED CTR- DEPT OF REHAB MEDICARE
NEW YORK, NY
10003-3314

Practice Phone: 212-420-2757
Practice Fax:

1194859637 — DUANE ANTHONY SIMIEN D.D.S.
Practice Location Address:

3201 GENERAL MEYER AVE STE B
NEW ORLEANS, LA
70114-3204

Practice Phone: 504-365-5573
Practice Fax: 504-365-0922

1043663214 — MARILLAC COMMUNITY HEALTH CENTERS
Practice Location Address:

3215 GENERAL MEYER AVE
NEW ORLEANS, LA
70114-3204

Practice Phone: 504-362-8930
Practice Fax: 504-362-8486

1093249518 — MARILLAC COMMUNITY HEALTH CENTERS
Practice Location Address:

2801 GENERAL DE GAULLE DRIVE , SUITE A
NEW ORLEANS, LA
70114-3204

Practice Phone: 504-362-8930
Practice Fax: 504-368-8486

1932565280 — KENNETH JOHNSON
Practice Location Address:

1138 N DUPRE ST
NEW ORLEANS, LA
70119-3204

Practice Phone: 504-330-1998
Practice Fax: 504-330-1998

1265880686 — ODYSSEY HOUSE, LA INC.
Practice Location Address:

1138 N DUPRE ST
NEW ORLEANS, LA
70119-3204

Practice Phone: 504-821-9211
Practice Fax:

Directions to “CHILDRENS CLINIC OF NEW ORLEANS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.