Provider Demographics
NPI:1477668168
Name:SAMPOGNARO, JOSEPH III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SAMPOGNARO
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3601 HOUMA BLVD
Mailing Address - Street 2:STE 402
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4310
Mailing Address - Country:US
Mailing Address - Phone:504-282-5398
Mailing Address - Fax:504-282-7232
Practice Address - Street 1:145 ROBERT E LEE BLVD
Practice Address - Street 2:STE. 402
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-2552
Practice Address - Country:US
Practice Address - Phone:504-282-5398
Practice Address - Fax:504-282-7232
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA013270207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1183300Medicaid
LA1183300Medicaid
LAB60288Medicare UPIN