# WJH PHYSICIAN SERVICES

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

## Provider details

- **NPI number:** 1417966193
- **Authorized official:** MRS. HEIDI A GWINN (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (504) 349-1297

## Contact information

- **Practice address:** 1101 MEDICAL CENTER BLVD, MEDICAL STAFF OFFICE, MARRERO, LA 70072-3147
- **Practice address phone:** (504) 349-1297
- **Practice address fax:** (504) 349-1146
- **Mailing address:** 1101 MEDICAL CENTER BLVD, MEDICAL STAFF OFFICE, MARRERO, LA 70072-3147
- **Mailing address phone:** (504) 349-1297
- **Mailing address fax:** (504) 349-1146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2085R0001X | Radiation Oncology Physician | 019052 | LA | — |
| 208600000X | Surgery Physician | 06267R | LA | — |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 03/03/2016