Provider Demographics
NPI:1851311195
Name:FEINBERG, EDGAR L II (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:L
Last Name:FEINBERG
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDGAR
Other - Middle Name:L
Other - Last Name:FEINBERG
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:312 GRAMMONT ST STE 410
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7411
Mailing Address - Country:US
Mailing Address - Phone:318-966-6300
Mailing Address - Fax:318-966-6301
Practice Address - Street 1:312 GRAMMONT ST STE 410
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7411
Practice Address - Country:US
Practice Address - Phone:318-966-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017672207R00000X, 208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA780002057OtherRR MEDICARE
LA1368156Medicaid
LA780002057OtherRR MEDICARE
LAC67653Medicare UPIN