Provider Demographics
NPI:1700808508
Name:LABAT, JOSEPH ALTON (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALTON
Last Name:LABAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 LAKE WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-3105
Mailing Address - Country:US
Mailing Address - Phone:504-246-1496
Mailing Address - Fax:
Practice Address - Street 1:360 OAK HARBOR BLVD
Practice Address - Street 2:SURGERY
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-726-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA02359R207RC0000X
LA02459R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1114987Medicaid
LA1114987Medicaid