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PONTCHARTRAIN PEDIATRICS LLC NPI 1881727691


NPI Information

NPI: 1881727691
Provider Name: PONTCHARTRAIN PEDIATRICS LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 19D0999066

Address:
4405 HIGHWAY 190 EAST SERVICE RD
COVINGTON, LA
ZIP 70433
Phone: (985) 893-8505
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PONTCHARTRAIN PEDIATRICS LLC is a pediatrics in Covington, LA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PONTCHARTRAIN PEDIATRICS LLC NPI is 1881727691. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4405 HIGHWAY 190 EAST SERVICE RD
COVINGTON, LA
ZIP 70433-957
Phone: (985) 893-8505
Fax: (985) 893-0093

The provider's authorized official is Vickie Jones .
The authorized official title is Office Manager and has the following contact phone number (985) 893-8505.

The CLIA number assigned to this NPI record is 19D0999066 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 1/5/2011.


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
1208000000XPediatricsLOUISIANAYes

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
11442810MEDICAIDLOUISIANA

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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