Provider Demographics
NPI:1346466703
Name:HAROLD R YORK MD
Entity Type:Organization
Organization Name:HAROLD R YORK MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:R
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-885-9957
Mailing Address - Street 1:4937 HEARST ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1120
Mailing Address - Country:US
Mailing Address - Phone:504-885-9957
Mailing Address - Fax:504-885-9987
Practice Address - Street 1:4937 HEARST ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1120
Practice Address - Country:US
Practice Address - Phone:504-885-9957
Practice Address - Fax:504-885-9987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD01047208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1940062Medicaid
LA=========OtherTAX ID NUMBER
LA1940062Medicaid