Provider Demographics
NPI:1396859880
Name:DECORTE, RAYMOND P (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:P
Last Name:DECORTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:STE 520
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006
Mailing Address - Country:US
Mailing Address - Phone:504-885-4833
Mailing Address - Fax:504-888-3132
Practice Address - Street 1:3901 HOUMA BLVD
Practice Address - Street 2:STE 500
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2930
Practice Address - Country:US
Practice Address - Phone:504-885-4833
Practice Address - Fax:504-888-3132
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA018188208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1977764Medicaid
LA1977764Medicaid
LAC70666Medicare UPIN