Provider Demographics
NPI:1669657490
Name:SANKAPHO MEDICAL GROUP PROFESSIONAL CORP
Entity type:Organization
Organization Name:SANKAPHO MEDICAL GROUP PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:CROPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-246-2119
Mailing Address - Street 1:1635 STEEPLE CHASE LN
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-7920
Mailing Address - Country:US
Mailing Address - Phone:504-246-2119
Mailing Address - Fax:504-246-0663
Practice Address - Street 1:8030 CROWDER BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-1063
Practice Address - Country:US
Practice Address - Phone:504-246-2119
Practice Address - Fax:504-246-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty