Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 24736 | LA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 24736 | LA |
NPI | 1366414732 |
---|---|
Provider Name | Mr. Christopher E Cenac JR. |
First Address | Houma, LA 70360-4629 |
Second Address | Houma, LA 70360-4629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1575038 | (05) | LA |
50922B275 | MEDICARE ID (01) | LA |
I37795 | (02) | |
P00600708 | MEDICARE RR (01) | LA |