Provider Demographics
NPI:1073387338
Name:PONTCHARTRAIN BONE & JOINT CLINIC, LTD.
Entity Type:Organization
Organization Name:PONTCHARTRAIN BONE & JOINT CLINIC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SKETCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-885-6464
Mailing Address - Street 1:3939 HOUMA BLVD STE 21
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2921
Mailing Address - Country:US
Mailing Address - Phone:506-885-6464
Mailing Address - Fax:504-247-0562
Practice Address - Street 1:14041 HWY 90
Practice Address - Street 2:
Practice Address - City:BOUTTE
Practice Address - State:LA
Practice Address - Zip Code:70039-3511
Practice Address - Country:US
Practice Address - Phone:985-764-3001
Practice Address - Fax:985-308-1458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies