Provider Demographics
NPI:1205934460
Name:JANUS MEDICAL GROUP
Entity type:Organization
Organization Name:JANUS MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JASMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-483-7112
Mailing Address - Street 1:PO BOX 19006
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70179-0006
Mailing Address - Country:US
Mailing Address - Phone:504-483-7112
Mailing Address - Fax:504-483-7116
Practice Address - Street 1:1215 N BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-3302
Practice Address - Country:US
Practice Address - Phone:504-483-7112
Practice Address - Fax:504-483-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CH90Medicare ID - Type Unspecified