Provider Demographics
NPI:1912054537
Name:CREAR-PERRY, JOIA ADELE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOIA
Middle Name:ADELE
Last Name:CREAR-PERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 EARHART BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-1743
Mailing Address - Country:US
Mailing Address - Phone:504-813-4450
Mailing Address - Fax:
Practice Address - Street 1:4747 EARHART BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1743
Practice Address - Country:US
Practice Address - Phone:504-813-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023616174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA721508761OtherTAX ID
LA1487848Medicaid
LA1487848Medicaid
LA4A481Medicare ID - Type Unspecified
LA1487848Medicaid