# JEFFERSON MEDICAL GROUP, LLC

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

## Provider details

- **NPI number:** 1912962150
- **Authorized official:** BRADLEY T. COLLINS MD (PRESIDENT)
- **Authorized official phone:** (504) 342-4708

## Contact information

- **Practice address:** 4228 HOUMA BLVD, STE. 600D, METAIRIE, LA 70006-3000
- **Practice address phone:** (504) 885-3003
- **Practice address fax:** (504) 885-3004
- **Mailing address:** 4228 HOUMA BLVD, STE. 600D, METAIRIE, LA 70006-3000
- **Mailing address phone:** (504) 885-3003
- **Mailing address fax:** (504) 885-3004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2006
- **Last updated:** 08/22/2020