Basic Information
| Provider Information | |||||||||
| NPI: | 1023374378 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOOSE | ||||||||
| FirstName: | MOLLY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 567 WINBOURNE DR | ||||||||
| Address2: | |||||||||
| City: | SLIDELL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704615099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044446860 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1430 TULANE AVENUE | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701122699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049887809 | ||||||||
| FaxNumber: | 5049883971 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2012 | ||||||||
| LastUpdateDate: | 10/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 303029 | LA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 303029 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.