Provider Demographics
NPI:1639479975
Name:ILEANA J TANDRON MD APMC
Entity Type:Organization
Organization Name:ILEANA J TANDRON MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TANDRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-643-9704
Mailing Address - Street 1:2240 GAUSE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4231
Mailing Address - Country:US
Mailing Address - Phone:985-643-9704
Mailing Address - Fax:
Practice Address - Street 1:2240 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4231
Practice Address - Country:US
Practice Address - Phone:985-643-9704
Practice Address - Fax:985-643-2813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty