Provider Demographics
NPI:1881773802
Name:JAYNE S GURTLER MD LAURA A BRINZ MD AND JANET BURROFF
Entity type:Organization
Organization Name:JAYNE S GURTLER MD LAURA A BRINZ MD AND JANET BURROFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GURTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-885-0577
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:STE 6
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2931
Mailing Address - Country:US
Mailing Address - Phone:504-885-0577
Mailing Address - Fax:504-888-7441
Practice Address - Street 1:3939 HOUMA BLVD
Practice Address - Street 2:STE 6
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-885-0577
Practice Address - Fax:504-888-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========0OtherBLUE CROSS
0346240001Medicare NSC
CI8926Medicare PIN
5D287Medicare PIN