Provider Demographics
NPI:1902035959
Name:TULANE UNIVERSITY SCHOOL OF MEDICINE
Entity Type:Organization
Organization Name:TULANE UNIVERSITY SCHOOL OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-988-5565
Mailing Address - Street 1:204 S SARATOGA ST
Mailing Address - Street 2:APT 427
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-4800
Mailing Address - Country:US
Mailing Address - Phone:305-798-9872
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE # SL-47
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-5565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPPLIED/ PENDING282N00000X
LAPENDING282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access