Organization
WEST JEFFERSON PHYSICIAN SERVICES
Active
Other names
Pediatric Specialty
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI A GWINN (CREDENTIALING COORD.)
(504) 349-1297
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE S650, MARRERO, LA 70072-3151
(504) 349-6504
(504) 349-6528
Mailing address
1111 MEDICAL CENTER BLVD, SUITE S650, MARRERO, LA 70072-3151
(504) 349-6504
(504) 349-6528
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942545
—
LA
Enumeration date
11/29/2006
Last updated
09/11/2025
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