Organization
JEFFERSON MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY T. COLLINS MD (PRESIDENT)
(504) 342-4708
Entity
Organization
Contact information
Practice address
4228 HOUMA BLVD, STE. 600D, METAIRIE, LA 70006-3000
(504) 885-3003
(504) 885-3004
Mailing address
4228 HOUMA BLVD, STE. 600D, METAIRIE, LA 70006-3000
(504) 885-3003
(504) 885-3004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1444464
—
LA
Enumeration date
04/19/2006
Last updated
08/22/2020
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