Provider Demographics
NPI:1891183596
Name:CHRIS LARTIGUE MD
Entity Type:Organization
Organization Name:CHRIS LARTIGUE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:W
Authorized Official - Last Name:LARTIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-237-8335
Mailing Address - Street 1:820 LAFITTE ST STE 107
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-5274
Mailing Address - Country:US
Mailing Address - Phone:985-624-5020
Mailing Address - Fax:985-624-5029
Practice Address - Street 1:820 LAFITTE ST STE 107
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-5274
Practice Address - Country:US
Practice Address - Phone:985-624-5020
Practice Address - Fax:985-624-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD06040R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty