| Alicia Clement Depaula, MD | |
|
1970 Ormond Blvd., Suite J, Destrehan, LA 70047 | |
| (504) 842-2980 | |
| (504) 842-2989 |
| Full Name | Alicia Clement Depaula |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1970 Ormond Blvd., Destrehan, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073613022 | NPI | - | NPPES |
| 1302384 | Medicaid | LA | |
| 09573718 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 19225 (Mississippi) | Secondary |
| 208000000X | Pediatrics | MD.202801 (Louisiana) | Primary |
| Entity Name | Ochsner Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538151428 PECOS PAC ID: 8224933619 Enrollment ID: O20031126000513 |
| Mailing Address | Practice Location Address |
|---|---|
| Alicia Clement Depaula, MD 1514 Jefferson Highway, New Orleans, LA 70121 Ph: (504) 842-4000 | Alicia Clement Depaula, MD 1970 Ormond Blvd., Suite J, Destrehan, LA 70047 Ph: (504) 842-2980 |
Dr. Kathryn Wiggins Melancon, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 13100 River Rd Ste 250, Destrehan, LA 70047 Phone: 985-764-6036 Fax: 985-764-0179 | |
Dolleen Licciardi, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 141 Ormond Center Ct, Destrehan, LA 70047 Phone: 985-764-7337 Fax: 985-764-5333 | |
Thomas Babin, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 141 Ormond Center Ct, Destrehan, LA 70047 Phone: 985-764-7337 Fax: 985-764-5333 |