Provider Demographics
NPI:1104556646
Name:PROSTHETIC SOLUTIONS INC.
Entity type:Organization
Organization Name:PROSTHETIC SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:III
Authorized Official - Credentials:CPO
Authorized Official - Phone:504-500-1349
Mailing Address - Street 1:4000 BIENVILLE ST STE D
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5163
Mailing Address - Country:US
Mailing Address - Phone:504-500-1349
Mailing Address - Fax:504-500-1352
Practice Address - Street 1:3280 DAUPHIN ST STE C105
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4050
Practice Address - Country:US
Practice Address - Phone:504-500-1349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2395866Medicaid