Provider Demographics
NPI:1699148114
Name:CRESCENT CITY MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:CRESCENT CITY MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-821-2574
Mailing Address - Street 1:7018 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-7403
Mailing Address - Country:US
Mailing Address - Phone:504-821-2574
Mailing Address - Fax:504-821-2595
Practice Address - Street 1:2930 CANAL ST
Practice Address - Street 2:SUITE 401
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6367
Practice Address - Country:US
Practice Address - Phone:504-821-2574
Practice Address - Fax:504-821-2595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD024150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty