Provider Demographics
NPI:1144229352
Name:THE MEDICAL ADVANTAGE, INC.
Entity Type:Organization
Organization Name:THE MEDICAL ADVANTAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:REYNARD
Authorized Official - Last Name:HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, HCM
Authorized Official - Phone:504-482-0600
Mailing Address - Street 1:225 N JEFFERSON DAVIS PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5309
Mailing Address - Country:US
Mailing Address - Phone:504-482-0600
Mailing Address - Fax:504-482-0029
Practice Address - Street 1:225 N JEFFERSON DAVIS PKWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5309
Practice Address - Country:US
Practice Address - Phone:504-482-0600
Practice Address - Fax:504-482-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL#0139812084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1444995Medicaid
LA5CE64Medicare ID - Type Unspecified