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Organization

LSUHSC MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JORGE MARTINEZ M.D (PROGRAM DIRECTOR)
(504) 568-3930
Entity
Organization

Contact information

Practice address
2020 GRAVIER ST, NEW ORLEANS, LA 70112-2272
(504) 568-3792
Mailing address
3101 CLEARY AVE, APT # 11, METAIRIE, LA 70002-7308
(504) 261-1789

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
GETP.LSU.IM
LA
281P00000X
Chronic Disease Hospital
GETP.LSU.IM
LA
282N00000X
General Acute Care Hospital
Primary
GETP.LSU.IM
LA
282NC0060X
Critical Access Hospital
GETP.LSU.IM
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1006831
MEDICAID PRESCRIBER
LA
Enumeration date
08/15/2007
Last updated
08/15/2007
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