Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 020685 | LA |
NPI | 1013023472 |
---|---|
Provider Name | Dr. Susan Diane Taylor |
First Address | New Orleans, LA 70115-5436 |
Second Address | New Orleans, LA 70115-3515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 18/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1969001 | (05) | LA |
B64212 | (02) | |
P00682234 | RAILROAD MCARE THRU PEPA (01) | LA |