Provider Demographics
NPI:1316005853
Name:KAILAS, INDIRA MOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:INDIRA
Middle Name:MOHAN
Last Name:KAILAS
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 1:3300 WEST ESPLANADE AVE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-838-5312
Mailing Address - Fax:504-838-5312
Practice Address - Street 1:5001 WESTBANK EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-349-8708
Practice Address - Fax:504-838-5714
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAR#005403, L#0170472084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1916544Medicaid
LA5D450Medicare ID - Type Unspecified
LAB61882Medicare UPIN