Provider Demographics
NPI:1528295219
Name:OCHSNER CLINIC LLC
Entity type:Organization
Organization Name:OCHSNER CLINIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AVP
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-842-7208
Mailing Address - Street 1:PO BOX 54851
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70154-4851
Mailing Address - Country:US
Mailing Address - Phone:504-842-3000
Mailing Address - Fax:504-842-6997
Practice Address - Street 1:102 W 112TH ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-3628
Practice Address - Country:US
Practice Address - Phone:985-632-1070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCHSNER CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-19
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57061Medicare PIN