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Organization
NORTHSHORE ONCOLOGY ASSOCIATES, LLC
Active
Organization
NORTHSHORE ONCOLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTI C SIEMANN (MEDICAL STAFF SVCS COORDINATOR)
(225) 215-1311
Entity
Organization
Contact information
Practice address
1120 ROBERT BLVD, STE 330, SLIDELL, LA 70458-2014
(985) 892-9090
(985) 892-9957
Mailing address
4950 ESSEN LANE, BATON ROUGE, LA 70809
(225) 215-1311
(225) 766-0218
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00938275
MISSISSIPPI MEDICAID
MS
05
—
2142089
—
LA
Enumeration date
03/30/2011
Last updated
05/01/2012
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