Provider Demographics
NPI:1548227986
Name:GULF SOUTH EYE ASSOCIATES APMC
Entity Type:Organization
Organization Name:GULF SOUTH EYE ASSOCIATES APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:FITZMORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-454-1000
Mailing Address - Street 1:4224 HOUMA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2933
Mailing Address - Country:US
Mailing Address - Phone:504-454-1000
Mailing Address - Fax:504-456-8010
Practice Address - Street 1:4224 HOUMA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2933
Practice Address - Country:US
Practice Address - Phone:504-454-1000
Practice Address - Fax:504-456-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1947181Medicaid
LA56674Medicare UPIN