Provider Demographics
NPI:1659394609
Name:CHESSON, RALPH RAYMOND JR (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:RAYMOND
Last Name:CHESSON
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 1:1340 POYDRAS ST
Mailing Address - Street 2:SUITE 1640
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1221
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD
Practice Address - Street 2:SUITE 600A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3000
Practice Address - Country:US
Practice Address - Phone:504-412-1600
Practice Address - Fax:504-780-8922
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10978R207VG0400X
LAMD.10978R207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02530708Medicaid
LA1656593Medicaid
MS00126381Medicaid
MS00126381Medicaid
NY02530708Medicaid
B06461Medicare UPIN
LA1656593Medicaid
LA5W025F670Medicare PIN
LA5W025Medicare PIN