Provider Demographics
NPI:1861434904
Name:KOONE, DONALD ADRIAN (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:ADRIAN
Last Name:KOONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 NAPOLEON AVE
Mailing Address - Street 2:#650
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-899-1114
Mailing Address - Fax:504-891-3217
Practice Address - Street 1:2820 NAPOLEON AVE
Practice Address - Street 2:#650
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-899-1114
Practice Address - Fax:504-891-3217
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06369R207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1361895Medicaid
LA52041Medicare ID - Type Unspecified
LA1361895Medicaid