Provider Demographics
NPI:1023261872
Name:SOUTH, ORVAL W
Entity type:Individual
Prefix:MR
First Name:ORVAL
Middle Name:W
Last Name:SOUTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 FRANCE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-5321
Mailing Address - Country:US
Mailing Address - Phone:504-947-8006
Mailing Address - Fax:504-947-8006
Practice Address - Street 1:716 FRANCE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-5321
Practice Address - Country:US
Practice Address - Phone:504-947-8006
Practice Address - Fax:504-947-8006
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other