Basic Information
Provider Information
NPI: 1003109364
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALBERT
FirstName: BRIAN
MiddleName: THOMAS
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1514 JEFFERSON HWY
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701212429
CountryCode: US
TelephoneNumber: 5048424000
FaxNumber:  
Practice Location
Address1: 1514 JEFFERSON HWY
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701212429
CountryCode: US
TelephoneNumber: 5048423910
FaxNumber: 5048424533
Other Information
ProviderEnumerationDate: 05/19/2011
LastUpdateDate: 08/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X259072MAN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X259072MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0003X331370LAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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