Provider Demographics
NPI:1659790871
Name:ROSSIGNOL, RANDY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:MICHAEL
Last Name:ROSSIGNOL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3600 PRYTANIA ST., STE. 35
Mailing Address - Street 2:CRESENT CITY PHYSICIANS, INC.
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3678
Mailing Address - Country:US
Mailing Address - Phone:504-897-7197
Mailing Address - Fax:504-249-5311
Practice Address - Street 1:100 W. HARRISON AVE. STE. 101
Practice Address - Street 2:SUITE 101
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124
Practice Address - Country:US
Practice Address - Phone:504-325-2929
Practice Address - Fax:504-325-2930
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2019-03-08
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Provider Licenses
StateLicense IDTaxonomies
LA301793207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2361121Medicaid