Provider Demographics
NPI:1689743163
Name:UDDO, JOSEPH FRANK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANK
Last Name:UDDO
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 1:4224 HOUMA BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2928
Mailing Address - Country:US
Mailing Address - Phone:504-454-4441
Mailing Address - Fax:504-456-5080
Practice Address - Street 1:4224 HOUMA BLVD STE 450
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2928
Practice Address - Country:US
Practice Address - Phone:504-454-4441
Practice Address - Fax:504-456-5080
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.016300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1358410Medicaid
LAB62967Medicare UPIN
LA51315Medicare ID - Type Unspecified