Provider Demographics
NPI:1982609483
Name:CARDIOLOGY CONSULTANTS OF LOUISIANA, APMC
Entity Type:Organization
Organization Name:CARDIOLOGY CONSULTANTS OF LOUISIANA, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:504-454-4120
Mailing Address - Street 1:PO BOX 7010
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70010-7010
Mailing Address - Country:US
Mailing Address - Phone:504-454-4120
Mailing Address - Fax:504-454-4192
Practice Address - Street 1:4200 HOUMA BLVD
Practice Address - Street 2:FL 2
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2970
Practice Address - Country:US
Practice Address - Phone:504-454-4120
Practice Address - Fax:504-454-4192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1794457Medicaid
MS9013677Medicare PIN
LA57643Medicare PIN
LA1794457Medicaid