Organization
USCG ISC
Active
Other names
USCG
Organization subpart
No
Provider details
NPI number
Authorized official
COX LISA (MEDICAL ASSISTANT)
(504) 253-6506
Entity
Organization
Contact information
Practice address
17800 OLD GENTILLT ROAD, NEW ORLEANS, LA 70129-6706
(504) 253-6506
Mailing address
70040 5TH ST, COVINGTON, LA 70433-6706
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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