Provider Demographics
NPI:1154357481
Name:SERBIN, VONNI GAY (MD)
Entity type:Individual
Prefix:
First Name:VONNI
Middle Name:GAY
Last Name:SERBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WREN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-4121
Mailing Address - Country:US
Mailing Address - Phone:504-881-1022
Mailing Address - Fax:504-456-8016
Practice Address - Street 1:1 WREN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-4121
Practice Address - Country:US
Practice Address - Phone:504-881-1022
Practice Address - Fax:504-456-8016
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016455207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1341444Medicaid
LA5M154B041Medicare ID - Type Unspecified
LA1341444Medicaid