Organization
RENEW BARIATRIC SURGERY. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUARY CILIAN OCONNELL MD (PRESIDENT)
(504) 897-0700
Entity
Organization
Contact information
Practice address
4429 CLARA ST, SUITE 600, NEW ORLEANS, LA 70115-6902
(504) 897-0700
(504) 897-0714
Mailing address
4429 CLARA ST, SUITE 600, NEW ORLEANS, LA 70115-6902
(504) 897-0700
(504) 897-0714
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
013995
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1182079
—
LA
Enumeration date
05/20/2008
Last updated
05/20/2008
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