Provider Demographics
NPI:1356431845
Name:SPRING, PAUL M
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:SPRING
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 1:3812 RIDGELAKE DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-7233
Mailing Address - Country:US
Mailing Address - Phone:504-454-1080
Mailing Address - Fax:504-455-4463
Practice Address - Street 1:3901 HOUMA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2927
Practice Address - Country:US
Practice Address - Phone:504-454-1080
Practice Address - Fax:504-455-4463
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAM.D.10918R207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1481955Medicaid
AR158046001Medicaid
G98824Medicare UPIN
LA1481955Medicaid