# DELUXE MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255899936
- **Authorized official:** BERTRAND TILLERY JR. MD (PHYSICIAN)
- **Authorized official phone:** (504) 418-5226

## Contact information

- **Practice address:** 3640 LAKE ASPEN DR W, GRETNA, LA 70056-8303
- **Practice address phone:** (504) 418-4226
- **Practice address fax:** (504) 365-9902
- **Mailing address:** 3640 LAKE ASPEN DR W, GRETNA, LA 70056-8303
- **Mailing address phone:** (504) 418-4226
- **Mailing address fax:** (504) 365-9902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/12/2019
- **Last updated:** 03/12/2019