Provider Demographics
NPI:1598935314
Name:PROWELL, CURTIS D JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:D
Last Name:PROWELL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 NEYREY DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2612
Mailing Address - Country:US
Mailing Address - Phone:504-906-0673
Mailing Address - Fax:
Practice Address - Street 1:4300 HOUMA BLVD FL 6
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2932
Practice Address - Country:US
Practice Address - Phone:504-503-4331
Practice Address - Fax:504-503-4341
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPGY.2.LSUN-IM207R00000X
LAMD.202723208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1507750Medicaid
LA1507750Medicaid