Provider Demographics
NPI:1275055618
Name:NORTHSHORE ANESTHESIA AND PAIN ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NORTHSHORE ANESTHESIA AND PAIN ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:985-640-4948
Mailing Address - Street 1:106 AYSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5034
Mailing Address - Country:US
Mailing Address - Phone:985-640-4948
Mailing Address - Fax:
Practice Address - Street 1:4324 VETERANS MEMORIAL BLVD # 101
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-5445
Practice Address - Country:US
Practice Address - Phone:504-309-4211
Practice Address - Fax:504-309-4214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty