Provider Demographics
NPI:1215306535
Name:BAUSEY MEDICAL SOLUTION
Entity type:Organization
Organization Name:BAUSEY MEDICAL SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:WILLIE
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:504-577-2258
Mailing Address - Street 1:8070 CROWDER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-1063
Mailing Address - Country:US
Mailing Address - Phone:504-577-2258
Mailing Address - Fax:504-510-2700
Practice Address - Street 1:8070 CROWDER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-1063
Practice Address - Country:US
Practice Address - Phone:504-577-2258
Practice Address - Fax:504-510-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care