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PONTCHARTRAIN CANCER CENTER NPI 1710286794


NPI Information

NPI: 1710286794
Provider Name: PONTCHARTRAIN CANCER CENTER
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
120 LAKEVIEW CIR
COVINGTON, LA
ZIP 70433
Phone: (985) 875-1202
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PONTCHARTRAIN CANCER CENTER is a specialist in Covington, LA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PONTCHARTRAIN CANCER CENTER NPI is 1710286794. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

120 LAKEVIEW CIR
COVINGTON, LA
ZIP 70433-512
Phone: (985) 875-1202
Fax: (985) 875-1205

The provider's authorized official is David Nelson Oubre .
The authorized official title is M.d.,/ Owner and has the following contact phone number (985) 419-0025.

The enumeration date for this NPI number is 3/16/2011 and was last updated on 1/10/2018.


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
1174400000XSpecialist22330LOUISIANAYes
2174400000XSpecialist203749LOUISIANANo
3174400000XSpecialistRN083847-AP04197LOUISIANANo

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
11665878MEDICAIDLOUISIANA
21478377MEDICAIDLOUISIANA
31883883MEDICAIDLOUISIANA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.