COMPREHENSIVE MEDICAL ASSOCIATES OF NEW ORLEANS LLC NPI 1194870782

NPI Information

NPI: 1194870782
Provider Name: COMPREHENSIVE MEDICAL ASSOCIATES OF NEW ORLEANS, LLC

Doing Business As: TILLERY FAMILY PRACTICE CLINIC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
4001 GEN DEGAULLE DR
SUITE H
NEW ORLEANS, LA
ZIP 70114
Phone: (504) 365-9906
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COMPREHENSIVE MEDICAL ASSOCIATES OF NEW ORLEANS, LLC is a primary care clinic center in New Orleans, LA. COMPREHENSIVE MEDICAL ASSOCIATES OF NEW ORLEANS, LLC NPI is 1194870782. The provider is registered as an organization entity type.
The provider Is Doing Business As Tillery Family Practice Clinic.

The provider's business location address is:

4001 GEN DEGAULLE DR
SUITE H
NEW ORLEANS, LA
ZIP 70114-220
Phone: (504) 365-9906
Fax: (504) 365-9902

The provider's authorized official is Bertrand Tillery .
The authorized official title is Physician and has the following contact phone number (504) 365-9906.

The CLIA number assigned to this NPI record is 19D1024340 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 12/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	025561	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1576794	MEDICAID	LOUISIANA
2	H43332	MEDICARE UPIN	LOUISIANA
3	4A475	MEDICARE ID-TYPE UNSPECIFIED	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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