Individual
JESSICA SOUMEE KOLLER GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-0663
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18252
NH
208600000X
Surgery Physician
Primary
310247
LA
Other
Enumeration date
05/04/2012
Last updated
09/21/2018
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