Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD.200361 | LA |
NPI | 1114118619 |
---|---|
Provider Name | Dr. Jeffrey William Surcouf |
First Address | New Orleans, LA 70112-2256 |
Second Address | New Orleans, LA 70112-2256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 20/05/2008 |