NPI 1083971006

Alvah Tyson Wickboldt, MD

Practitioner Pain Medicine Physician New Orleans, LA

Practice location

Address: 1514 Jefferson Hwy Brent House Room 634, New Orleans, LA 70121-2429
Phone: (504) 842-3000
Mailing address: 1514 Jefferson Highway, New Orleans, LA 70121-2429

Registered specialties (2)

Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0000X Licence 305062 (LA)

Other Pain Medicine providers in Louisiana →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1083971006
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Apr 2012
Record last updated: 21 Jul 2022

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.