Individual
NATHAN TAILLAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-7511
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
310801
LA
207R00000X
Internal Medicine Physician
66275
TN
390200000X
Student in an Organized Health Care Education/Training Program
917774298
AR
Other
Enumeration date
04/15/2015
Last updated
09/09/2022
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