Provider Demographics
NPI:1235453242
Name:CARONA, ADRIENNE ADELE ARBOUR (MD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:ADELE ARBOUR
Last Name:CARONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3037
Mailing Address - Country:US
Mailing Address - Phone:504-390-2990
Mailing Address - Fax:
Practice Address - Street 1:1542 TULANE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2865
Practice Address - Country:US
Practice Address - Phone:504-568-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA205522207R00000X
390200000X
LAMD.205522207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2105957Medicaid
MS03706525Medicaid
LA2105957Medicaid