Organization
USCG ISC NEW ORLEANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE WALTON (HSC)
(504) 253-6506
Entity
Organization
Contact information
Practice address
1800 OLD GENTILLY ROAD, NEW ORLEANS, LA 70129
(504) 253-6506
Mailing address
1800 OLD GENTILLY ROAD, NEW ORLEANS, LA 70129
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
LA
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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