Provider Demographics
NPI:1912902941
Name:ARRIAGA, MOISES ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:MOISES
Middle Name:ALBERTO
Last Name:ARRIAGA
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 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE 709
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-765-7735
Mailing Address - Fax:225-765-1023
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 709
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-765-7735
Practice Address - Fax:225-765-1023
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3038207YX0901X
PAMD037934-E207YX0901X
LAMD200006207YX0901X
CAG66176207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06327314Medicaid
LA1479144Medicaid
MS06327314Medicaid
LA1479144Medicaid
LA248177YJA2Medicare PIN
LA248177YJA2Medicare PIN