Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 200770 | LA |
N | 207XS0106X | Orthopaedic Hand Surgeon | 200770 | LA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD.200770 | LA |
NPI | 1053581710 |
---|---|
Provider Name | Leslie Elaine Sisco |
First Address | New Orleans, LA 70121-2272 |
Second Address | New Orleans, LA 70121-2429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2008 |
Last Update Date | 23/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06474574 | (05) | MS |
1074713 | (05) | LA |