MEDICARE: COASTAL ORTHOPAEDIC SPECIALISTS LLC

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1699746412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL ORTHOPAEDIC SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	210 NEW ORLEANS BLVD
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70364
Country	:	US
Telephone Number	:	985-868-7020
Fax Number	:	985-872-6869

Provider Business Practice Location Address
First Line	:	210 NEW ORLEANS BLVD
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70364
Country	:	US
Telephone Number	:	985-868-7020
Fax Number	:	985-872-6869

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CHRISTOPHER E CENAC JR.
Credential	:	MD
Telephone Number	:	985-868-7020

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	08/22/2020

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