Provider Demographics
NPI:1528177532
Name:ORLEANS ORTHOPAEDIC ASSOCIATES, LLC
Entity type:Organization
Organization Name:ORLEANS ORTHOPAEDIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:COUVILLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-896-3842
Mailing Address - Street 1:3715 PRYTANIA ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3761
Mailing Address - Country:US
Mailing Address - Phone:504-895-2055
Mailing Address - Fax:504-896-3870
Practice Address - Street 1:3715 PRYTANIA ST
Practice Address - Street 2:SUITE 501
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3761
Practice Address - Country:US
Practice Address - Phone:504-895-2055
Practice Address - Fax:504-896-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1443891Medicaid
LAG4021OtherBLUE CROSS/BLUE SHIELD
LA=========OtherTRICARE
LAG4021OtherBLUE CROSS/BLUE SHIELD
LA1443891Medicaid
LA=========OtherTRICARE
LA5CD40Medicare ID - Type UnspecifiedOOA GROUP #