Provider Demographics
NPI:1649436080
Name:MOREHOUSE HYPERBARIC MEDICINE PROVIDERS, LLC
Entity type:Organization
Organization Name:MOREHOUSE HYPERBARIC MEDICINE PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHORETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-283-3896
Mailing Address - Street 1:323 W WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-4521
Mailing Address - Country:US
Mailing Address - Phone:318-283-3896
Mailing Address - Fax:318-283-3644
Practice Address - Street 1:323 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-4521
Practice Address - Country:US
Practice Address - Phone:318-283-3896
Practice Address - Fax:318-283-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA009199173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty