Provider Demographics
NPI:1720655624
Name:PREVOT, LOUIS LEONARD JR
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:LEONARD
Last Name:PREVOT
Suffix:JR
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 1:7631 FIELDSTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2056
Mailing Address - Country:US
Mailing Address - Phone:504-635-8600
Mailing Address - Fax:
Practice Address - Street 1:7631 FIELDSTON RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-2056
Practice Address - Country:US
Practice Address - Phone:504-635-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)