Provider Demographics
NPI:1699966903
Name:MOVSESYAN, ARAKEL
Entity type:Individual
Prefix:DR
First Name:ARAKEL
Middle Name:
Last Name:MOVSESYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ESPLANADE AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2489
Mailing Address - Country:US
Mailing Address - Phone:678-687-2302
Mailing Address - Fax:
Practice Address - Street 1:200 W ESPLANADE AVE STE 409
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2474
Practice Address - Country:US
Practice Address - Phone:504-471-2757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD203797207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1006360Medicaid