Provider Demographics
NPI:1649479676
Name:NORTH OAKS ANESTHESIOLOGY ASSOCIATES LLC
Entity type:Organization
Organization Name:NORTH OAKS ANESTHESIOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRISOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-902-9763
Mailing Address - Street 1:PO BOX 1516
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1516
Mailing Address - Country:US
Mailing Address - Phone:985-345-8867
Mailing Address - Fax:
Practice Address - Street 1:15790 PAUL VEGA MD DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1434
Practice Address - Country:US
Practice Address - Phone:985-902-9763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1013692Medicaid
MS04670215Medicaid
LADG4122Medicare PIN
MS04670215Medicaid