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Organization

NORTHLAKE ANESTHESIOLOGISTS, A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTHONY JOSEPH SCURRIA MD (VICE PRESIDENT)
(504) 717-5387
Entity
Organization

Contact information

Practice address
636 GAUSE BLVD STE 300, SLIDELL, LA 70458-2007
(985) 649-4063
(985) 649-2833
Mailing address
636 GAUSE BLVD, SUITE 300, SLIDELL, LA 70458-2007
(985) 649-4063
(985) 649-2833

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1796450
LA
01
26676
BLUE CROSS
LA
Enumeration date
09/06/2006
Last updated
09/22/2022
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