Provider Demographics
NPI:1154854347
Name:ALABASTER, KELSEY LEE (MD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LEE
Last Name:ALABASTER
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 1:441 GRAVIER ST APT 6
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-2400
Mailing Address - Country:US
Mailing Address - Phone:901-378-1790
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3006
Practice Address - Country:US
Practice Address - Phone:504-264-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA306087208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program