Provider Demographics
NPI:1760458566
Name:DIGRADO, CHRIS J (MD)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:J
Last Name:DIGRADO
Suffix:
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 1:1301 BARATARIA BLVD
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3703
Mailing Address - Country:US
Mailing Address - Phone:504-347-0243
Mailing Address - Fax:504-349-2910
Practice Address - Street 1:1301 BARATARIA BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3703
Practice Address - Country:US
Practice Address - Phone:504-347-0243
Practice Address - Fax:504-349-2910
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.012266207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1173631Medicaid
LA200039438OtherRAILROAD MEDICARE
LA5L757Medicare PIN