NPI 1700354453

Oh Project- Northshore

Organisation General Practice Physician Covington, LA

Practice location

Address: 190 Greenbrier Blvd STE 105, Covington, LA 70433-7237
Phone: (985) 276-3040
Mailing address: PO Box 957, Madisonville, LA 70447-0957

Authorised official

Name: Tyrone Luster
Title: Owner
Phone: (901) 626-2129

Registered specialties (3)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Louisiana →

Mental Health Clinic/Center (Including Community Mental Health Center)

Ambulatory Health Care Facilities Taxonomy 261QM0801X

Other Clinic/Center providers in Louisiana →

Family Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X

Other Nurse Practitioner providers in Louisiana →

Registry record

NPI: 1700354453
Entity type: Organization
NPI issued: 9 Nov 2018
Record last updated: 9 Nov 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.