Organization
EVANS ELYSIAN FIELDS NEW ORLEANS MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MONTGOMERY (OFFICE MANAGER)
(504) 284-3866
Entity
Organization
Contact information
Practice address
4301 ELYSIAN FIELDS AVE, NEW ORLEANS, LA 70122-3875
(504) 284-3866
Mailing address
4301 ELYSIAN FIELDS AVE, NEW ORLEANS, LA 70122-3875
(504) 284-3866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942421
—
LA
Enumeration date
01/18/2012
Last updated
01/18/2012
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