Organization
WJH PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEIDI A GWINN (CREDENTIALING COORDINATOR)
(504) 349-1297
Entity
Organization
Contact information
Practice address
1101 MEDICAL CENTER BLVD, MEDICAL STAFF OFFICE, MARRERO, LA 70072-3147
(504) 349-1297
(504) 349-1146
Mailing address
1101 MEDICAL CENTER BLVD, MEDICAL STAFF OFFICE, MARRERO, LA 70072-3147
(504) 349-1297
(504) 349-1146
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2085R0001X
Radiation Oncology Physician
019052
LA
208600000X
Surgery Physician
06267R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942545
—
LA
Enumeration date
08/05/2006
Last updated
03/03/2016
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