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Contact Information

CRESCENT CITY DERMATOLOGY, LLC
120 MEADOWCREST ST
SUITE 460
GRETNA, LA70056-5255
 Phone: 614-937-0319
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for CRESCENT CITY DERMATOLOGY, LLC

NPI Number 1518100312
LBN Legal business name CRESCENT CITY DERMATOLOGY, LLC
Authorized official STEPHEN KLINGER - (PART OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/09/2009
Last updated 04/15/2009 - About 17 years ago
Identifiers
LA License # 200999
LA Medicaid 1216887
Other 1356531677 NPI NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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