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Organization

CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION

Active
Parent organization
CHILDREN'S HOSPITAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHILDREN'S HOSPITAL
Authorized official
MR. MATT GRONINGER (EXECUTIVE DIRECTOR)
(504) 894-6771
Entity
Organization

Contact information

Practice address
298 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9827
(504) 894-5370
Mailing address
298 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9827
(504) 894-5370

Taxonomy

Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
256
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1946711
LA
Enumeration date
10/18/2010
Last updated
05/10/2018
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