Provider Demographics
NPI:1073559357
Name:LONSETH, ERIC DANIEL (MD)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DANIEL
Last Name:LONSETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 TEUTON ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4123
Mailing Address - Country:US
Mailing Address - Phone:504-327-5857
Mailing Address - Fax:504-324-3569
Practice Address - Street 1:4213 TEUTON ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4123
Practice Address - Country:US
Practice Address - Phone:504-327-5857
Practice Address - Fax:504-324-3569
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93735207L00000X, 207LP2900X, 208VP0014X
LAMD026075208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1051667Medicaid
LADF2307OtherRAILROAD MEDICARE
4K786Medicare PIN
LA4K786DH10Medicare PIN
LA1051667Medicaid
5CV11OtherGROUP PTAN