Provider Demographics
NPI:1699143065
Name:PHAM OBGYN LLC
Entity type:Organization
Organization Name:PHAM OBGYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:
Authorized Official - First Name:HUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-324-8760
Mailing Address - Street 1:4626 ALCEE FORTIER BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-2130
Mailing Address - Country:US
Mailing Address - Phone:504-324-8760
Mailing Address - Fax:504-324-9074
Practice Address - Street 1:4626 ALCEE FORTIER BLVD STE D
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70129-2130
Practice Address - Country:US
Practice Address - Phone:504-324-8760
Practice Address - Fax:504-324-9074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty