Provider Demographics
NPI:1972832533
Name:JOHN H VOCKROTH M.D. LLC
Entity type:Organization
Organization Name:JOHN H VOCKROTH M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:VOCKROTH
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:505-261-4499
Mailing Address - Street 1:6324 PARIS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-2847
Mailing Address - Country:US
Mailing Address - Phone:504-261-4499
Mailing Address - Fax:
Practice Address - Street 1:6324 PARIS AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-2847
Practice Address - Country:US
Practice Address - Phone:504-261-4499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10349R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1986721Medicaid
LAF77193Medicare UPIN