Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 309024 | LA |
NPI | 1003298456 |
---|---|
Provider Name | Madeline Cozad |
First Address | New Orleans, LA 70112-3018 |
Second Address | New Orleans, LA 70112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 20/12/2018 |