Provider Demographics
NPI:1154500023
Name:TUHC PHYSICIAN GROUP LLC
Entity Type:Organization
Organization Name:TUHC PHYSICIAN GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGESSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-988-7535
Mailing Address - Street 1:1415 TULANE AVE
Mailing Address - Street 2:HC71
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2600
Mailing Address - Country:US
Mailing Address - Phone:504-988-7535
Mailing Address - Fax:504-988-6288
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:HC71
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-988-7535
Practice Address - Fax:504-988-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529932964Medicaid
MS03828594Medicaid
LA1024341Medicaid
DG8737Medicare PIN
LA1024341Medicaid