Provider Demographics
NPI:1750346938
Name:COSGRIFF, THOMAS M (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:COSGRIFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4204 HOUMA BLVD
Mailing Address - Street 2:FL 2
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2903
Mailing Address - Country:US
Mailing Address - Phone:504-883-2968
Mailing Address - Fax:504-883-2973
Practice Address - Street 1:4204 HOUMA BLVD
Practice Address - Street 2:FLOOR 2
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2903
Practice Address - Country:US
Practice Address - Phone:504-883-2968
Practice Address - Fax:504-883-2973
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA09581R207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1672319Medicaid
F45632Medicare UPIN
LA363820YT3RMedicare PIN
LA1672319Medicaid
LA5R542Medicare PIN