# CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHILDREN'S HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962712521
- **Legal business name:** CHILDREN'S HOSPITAL
- **Authorized official:** MR. MATT GRONINGER (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (504) 894-6771

## Contact information

- **Practice address:** 298 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
- **Practice address phone:** (504) 896-9827
- **Practice address fax:** (504) 894-5370
- **Mailing address:** 298 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
- **Mailing address phone:** (504) 896-9827
- **Mailing address fax:** (504) 894-5370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | 256 | LA | Yes |

## Other

- **Enumeration date:** 10/18/2010
- **Last updated:** 05/10/2018