Provider Demographics
NPI:1295984961
Name:MALSBURY, JENNIFER MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:MALSBURY
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Gender:F
Credentials:DO
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Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:RIVER REGION SURGICAL SPECIALISTS
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 1:502 RUE DE SANTE STE 105
Practice Address - Street 2:RIVER REGION SURGICAL SPECIALISTS
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5424
Practice Address - Country:US
Practice Address - Phone:985-653-1605
Practice Address - Fax:985-653-1609
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2016-05-27
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Provider Licenses
StateLicense IDTaxonomies
LADO.000248208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2154371Medicaid
MS09802721OtherMEDICAID
LA249037YH3UMedicare PIN