Provider Demographics
NPI:1912197575
Name:WAX, BARTON LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTON
Middle Name:LLOYD
Last Name:WAX
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 1:920 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3112
Mailing Address - Country:US
Mailing Address - Phone:504-349-6804
Mailing Address - Fax:504-349-6844
Practice Address - Street 1:920 AVENUE B
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3112
Practice Address - Country:US
Practice Address - Phone:504-349-6804
Practice Address - Fax:504-349-6844
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203240207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery