Provider Demographics
NPI:1689722340
Name:CRESCENT CITY PHYSICIANS, INC.
Entity Type:Organization
Organization Name:CRESCENT CITY PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:KRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-897-7794
Mailing Address - Street 1:3600 PRYTANIA ST
Mailing Address - Street 2:SUITE 35
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3672
Mailing Address - Country:US
Mailing Address - Phone:504-897-8315
Mailing Address - Fax:504-891-9862
Practice Address - Street 1:3600 PRYTANIA ST
Practice Address - Street 2:SUITE 35
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3672
Practice Address - Country:US
Practice Address - Phone:504-897-8315
Practice Address - Fax:504-891-9862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207Q00000X, 207R00000X, 207V00000X, 2085R0001X, 208600000X, 208800000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1943479Medicaid
LA5D516Medicare PIN
LA5D913Medicare PIN
LA1943479Medicaid