Provider Demographics
NPI:1164411161
Name:OCHSNER, JESSICA COLLER (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:COLLER
Last Name:OCHSNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:J
Other - Middle Name:COLLER
Other - Last Name:OCHSNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2323 METAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5561
Mailing Address - Country:US
Mailing Address - Phone:504-831-6633
Mailing Address - Fax:504-831-6654
Practice Address - Street 1:2323 METAIRIE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5561
Practice Address - Country:US
Practice Address - Phone:504-831-6633
Practice Address - Fax:504-831-6654
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD015824207KA0200X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1342238Medicaid
LA5L665CK96Medicare PIN
D79712Medicare UPIN