Basic Information
| Provider Information | |||||||||
| NPI: | 1326595968 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOUISIANA STATE UNIVERSITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3316 44 B AVENUE | ||||||||
| Address2: | |||||||||
| City: | EDMONTON | ||||||||
| State: | AB | ||||||||
| PostalCode: | T6T1E8 | ||||||||
| CountryCode: | CA | ||||||||
| TelephoneNumber: | 7804400149 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2000 CANAL STREET | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701123018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5047023000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2016 | ||||||||
| LastUpdateDate: | 09/01/2016 | ||||||||
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| AuthorizedOfficialLastName: | DOUGHTY | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 5045684682 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 303413 | LA | Y | Hospitals | General Acute Care Hospital |
No ID Information.