Provider Demographics
NPI:1407921935
Name:JULIUS, SUSAN FRANCES (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:FRANCES
Last Name:JULIUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:FRANCES
Other - Last Name:SUMERGRAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:195 HIGHLAND PARK PLZ STE 100
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7128
Mailing Address - Country:US
Mailing Address - Phone:504-605-1484
Mailing Address - Fax:504-356-0333
Practice Address - Street 1:2414 BUNKER HILL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3303
Practice Address - Country:US
Practice Address - Phone:225-590-7472
Practice Address - Fax:225-495-4140
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022649207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1480223Medicaid
LA4E120OtherINDIVIDUAL PROVIDER NUMBER
LA4E120OtherINDIVIDUAL PROVIDER NUMBER