MEDICARE: JOSEPH ANDREW MATHER MD

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	MD.205907	LA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1942591458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH ANDREW MATHER MD

Provider Business Mailing Address
First Line	:	3601 HOUMA BLVD STE 300
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006-4310
Country	:	US
Telephone Number	:	504-885-7360
Fax Number	:	504-885-1360

Provider Business Practice Location Address
First Line	:	3601 HOUMA BLVD STE 300
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006-4310
Country	:	US
Telephone Number	:	504-885-7360
Fax Number	:	504-885-1360

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

Provider Enumeration Date	:	05/02/2011
Last Update Date	:	02/08/2017

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