Provider Demographics
NPI:1508870783
Name:CASEY, STEPHANIE D (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:D
Last Name:CASEY
Suffix:
Gender:F
Credentials:MD, MPH
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 GRAVIER ST., 7TH FLOOR
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY, LSU HEALTH SCIENCES CENTER
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-568-4647
Mailing Address - Fax:504-568-8955
Practice Address - Street 1:2020 GRAVIER ST FL 7
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY, LSU HEALTH SCIENCES CENTER
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2272
Practice Address - Country:US
Practice Address - Phone:504-568-4647
Practice Address - Fax:504-568-8955
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA944532085R0202X
LAMD.0255742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0930965Medicaid
LA1043214Medicaid
LA4K6697061Medicare PIN
LA1043214Medicaid