Organization
CRESCENT CITY DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN JOHN KLINGER M.D., M.P.H. (PART OWNER)
(614) 937-0319
Entity
Organization
Contact information
Practice address
120 MEADOWCREST ST, SUITE 460, GRETNA, LA 70056-5255
(614) 937-0319
Mailing address
1107 S PETERS ST, UNIT 404, NEW ORLEANS, LA 70130-1759
(614) 937-0319
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
200999
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1216887
—
LA
01
—
1356531677
NPI NUMBER
—
Enumeration date
04/09/2009
Last updated
04/15/2009
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