Individual
SOPHY ANN JANCICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
120 OCHSNER BLVD STE 310, GRETNA, LA 70056
(504) 595-8014
(504) 595-8115
Mailing address
120 OCHSNER BLVD. SUITE 310, GRETNA, LA 70056
(504) 595-8014
(504) 595-8115
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
023710
LA
207RX0202X
Medical Oncology Physician
Primary
MD.023710
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01061634A
MEDICAL LICENSE #
IN
05
—
04286541
—
MS
05
—
1484571
—
LA
01
—
35577
MEDICAL LICENSE #
AZ
01
—
MD00046564
MEDICAL LICENSE #
WA
Enumeration date
06/13/2006
Last updated
07/21/2022
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