MEDICARE: LOUISIANA PAIN 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	208VP0014X	Interventional Pain Medicine 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	:	1871823740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISIANA PAIN SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	2706 HESSMER AVE STE A
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-7046
Country	:	US
Telephone Number	:	504-754-2334
Fax Number	:	504-324-2078

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	:	504-324-2078

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	CORRIE SPANO
Credential	:
Telephone Number	:	504-635-2601

Provider Enumeration Date	:	12/28/2009
Last Update Date	:	01/21/2025

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