Provider Demographics
NPI:1952481582
Name:SASSONE, RANDOLPH E (MD)
Entity Type:Individual
Prefix:
First Name:RANDOLPH
Middle Name:E
Last Name:SASSONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RANDY
Other - Middle Name:E
Other - Last Name:SASSONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HIGHWAY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121
Practice Address - Country:US
Practice Address - Phone:504-842-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.019615207L00000X
MS12926207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1916501Medicaid
MS00016855Medicaid
LA4M847Medicare PIN
LA1916501Medicaid
LA4M8477061Medicare PIN