Provider Demographics
NPI:1184689507
Name:COLON & RECTAL SURGERY ASSOCIATES
Entity Type:Organization
Organization Name:COLON & RECTAL SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-456-5108
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:SUITE 540
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2933
Mailing Address - Country:US
Mailing Address - Phone:504-456-5108
Mailing Address - Fax:504-456-5109
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:SUITE 540
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-456-5108
Practice Address - Fax:504-456-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CE04Medicare ID - Type Unspecified
LA5B848Medicare ID - Type Unspecified