Provider Demographics
NPI:1508820317
Name:HEMATOLOGY & ONCOLOGY SPECIALISTS LLC
Entity Type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE COMMITTEE
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:COSGRIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-883-2960
Mailing Address - Street 1:PO BOX 54932
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70154
Mailing Address - Country:US
Mailing Address - Phone:504-883-2960
Mailing Address - Fax:504-883-2967
Practice Address - Street 1:4228 HOUMA BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3000
Practice Address - Country:US
Practice Address - Phone:504-883-2960
Practice Address - Fax:504-883-2967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1947041Medicaid
LA1947041Medicaid
LA1190500007Medicare NSC
LA1190500008Medicare NSC
LA1190500011Medicare NSC