Individual
ASAHEL L GRIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1850 GAUSE BLVD E, SUITE 202, SLIDELL, LA 70461-5442
(985) 639-3777
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
24075
MS
208600000X
Surgery Physician
Primary
MD.203729
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03839737
—
MS
05
—
1106089
—
LA
Enumeration date
06/12/2008
Last updated
07/11/2016
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