Provider Demographics
NPI:1861424749
Name:TULANE UNIVERSITY HOSPITAL & CLINIC
Entity type:Organization
Organization Name:TULANE UNIVERSITY HOSPITAL & CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-988-5314
Mailing Address - Street 1:1430 TULANE AVENUE, SL-69
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-988-5804
Mailing Address - Fax:504-988-2684
Practice Address - Street 1:1415 TULANE AVENUE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-988-5804
Practice Address - Fax:504-988-2684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04413R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB60788Medicare UPIN
LA5K226CR58Medicare ID - Type UnspecifiedPROVIDER NUMBER