Provider Demographics
NPI:1992958326
Name:THE BONE & JOINT CLINIC OF HAMMOND, LLC
Entity type:Organization
Organization Name:THE BONE & JOINT CLINIC OF HAMMOND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CHIASSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-350-6505
Mailing Address - Street 1:1000 J W DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5908
Mailing Address - Country:US
Mailing Address - Phone:985-350-6505
Mailing Address - Fax:985-350-6509
Practice Address - Street 1:1000 J W DAVIS DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5908
Practice Address - Country:US
Practice Address - Phone:985-350-6505
Practice Address - Fax:985-350-6509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.021220207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1366455Medicaid
LADO6873OtherMEDICARE RAILROAD
LA6175360002OtherCIGNA GOVERNMENT SERVICE / PALMETTO GBA DME
LA1366455Medicaid
5DH38Medicare PIN