Provider Demographics
NPI:1326595968
Name:LOUISIANA STATE UNIVERSITY
Entity Type:Organization
Organization Name:LOUISIANA STATE UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGHTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-568-4682
Mailing Address - Street 1:3316 44 B AVENUE
Mailing Address - Street 2:
Mailing Address - City:EDMONTON
Mailing Address - State:AB
Mailing Address - Zip Code:T6T1E8
Mailing Address - Country:CA
Mailing Address - Phone:780-440-0149
Mailing Address - Fax:
Practice Address - Street 1:2000 CANAL STREET
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3018
Practice Address - Country:US
Practice Address - Phone:504-702-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA303413282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital