Provider Demographics
NPI:1972042810
Name:OCHSNER CLINIC LLC
Entity Type:Organization
Organization Name:OCHSNER CLINIC LLC
Other - Org Name:OCHSNER URGENT CARE - LULING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AVP
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-842-7208
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:12895 HIGHWAY 90
Practice Address - Street 2:STE H
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-2249
Practice Address - Country:US
Practice Address - Phone:985-331-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCHSNER CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA56629Medicare PIN