Provider Demographics
NPI:1699746412
Name:COASTAL ORTHOPAEDIC SPECIALISTS LLC
Entity type:Organization
Organization Name:COASTAL ORTHOPAEDIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:CENAC
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:985-868-7020
Mailing Address - Street 1:210 NEW ORLEANS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364
Mailing Address - Country:US
Mailing Address - Phone:985-868-7020
Mailing Address - Fax:985-872-6869
Practice Address - Street 1:210 NEW ORLEANS BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364
Practice Address - Country:US
Practice Address - Phone:985-868-7020
Practice Address - Fax:985-872-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5CS03Medicare ID - Type Unspecified