Provider Demographics
NPI:1013493725
Name:MED-CORP MANAGEMENT, L.L.C.
Entity type:Organization
Organization Name:MED-CORP MANAGEMENT, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:504-319-6734
Mailing Address - Street 1:3801 CANAL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6043
Mailing Address - Country:US
Mailing Address - Phone:504-319-7431
Mailing Address - Fax:504-644-4889
Practice Address - Street 1:3801 CANAL ST STE 100
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6043
Practice Address - Country:US
Practice Address - Phone:504-319-7431
Practice Address - Fax:504-644-4889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty