Provider Demographics
NPI:1851391270
Name:SANCHEZ, JORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:SANCHEZ
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 1:550 BROWNSWITCH RD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1104
Mailing Address - Country:US
Mailing Address - Phone:985-646-1400
Mailing Address - Fax:985-646-1443
Practice Address - Street 1:550 BROWNSWITCH RD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1104
Practice Address - Country:US
Practice Address - Phone:985-646-1400
Practice Address - Fax:985-646-1443
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017081207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA200003461OtherRAILROAD MEDICARE
LA1328171Medicaid
LA55814Medicare ID - Type Unspecified
LA1328171Medicaid
LAB65866Medicare UPIN