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CAMELLIA CITY OBSTETRICS AND GYNECOLOGY NPI 1184634040


NPI Information

NPI: 1184634040
Provider Name: CAMELLIA CITY OBSTETRICS AND GYNECOLOGY
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 19D0964187

Address:
1150 ROBERT BLVD
SUITE 360
SLIDELL, LA
ZIP 70458
Phone: (985) 781-4848
Get Directions

CAMELLIA CITY OBSTETRICS AND GYNECOLOGY is an obstetrics gynecology in Slidell, LA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. CAMELLIA CITY OBSTETRICS AND GYNECOLOGY NPI is 1184634040. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1150 ROBERT BLVD
SUITE 360
SLIDELL, LA
ZIP 70458-004
Phone: (985) 781-4848
Fax: (985) 781-4850

The provider's authorized official is Diana Clavin .
The authorized official title is Authorized Agent and has the following contact phone number (985) 781-4848.

The CLIA number assigned to this NPI record is 19D0964187 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/9/2006 and was last updated on 2/24/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & Gynecology90577LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15U504DS23OTHERLOUISIANAMEDICARE LA LINKING NO. - ANN R. LOBELLO, MD
25DS23MEDICARE PINLOUISIANA
35W897DS23OTHERLOUISIANAMEDICARE LA LINKING NO. DIANA K. CLAVIN, MD
42113381MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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