ALVAH TYSON WICKBOLDT JR. (NPI# 1083971006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083971006 |
| Entity Type | Individual |
| Full Name | ALVAH TYSON WICKBOLDT JR. |
| Credential | M.D. |
| Practice Address |
1514 Jefferson Hwy Brent House Room 634 New Orleans LA 70121-2429 |
| Mailing Address |
1514 Jefferson Highway New Orleans LA 70121-2429 |
| Practice Telephone | 5048423000 |
| Mailing Telephone | (504) 842-3000 |
| Enumeration Date | 2012-04-15 |
| Last Update Date | 2017-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
305062 | LA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1514 JEFFERSON HWY BRENT HOUSE ROOM 634 |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70121-2429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053314419 | Kirt Joseph Talamo | Physician Assistant | 1514 Jefferson Hwy, New Orleans, LA 70121 | 2005-05-31 |
| 1902406481 | Katelynn Templet | Pharmacist | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-10-26 |
| 1023617552 | Emily Kate Durham Arceneaux | Physician Assistant | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-10-26 |
| 1285232629 | Sunni J Primeaux | Psychologist | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-10-16 |
| 1417554965 | Jillian E Pringle | Nurse Practitioner | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-10-07 |
| 1972110278 | Kaitlyn M Reine | Physician Assistant | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-09-30 |
| 1811504657 | William L Rasmussen | Nurse Practitioner | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-09-25 |
| 1376157545 | Justin Carreras | Psychologist | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-09-03 |
| 1114531852 | Rachel Rovira | Physician Assistant | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-09-01 |
| 1578174686 | Tamara Lafont | Nurse Practitioner | 1514 Jefferson Hwy, New Orleans, LA 70121-2429 | 2020-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437772191 | Carlos Andres Cevallos | Student in an Organized Health Care Education/Training Program | 1514 Jefferson Hwy, New Orleans, LA 70121 | 2020-05-28 |
| 1497375257 | Vipin Varghese | Student in an Organized Health Care Education/Training Program | 1514 Jefferson Hwy, Bh 629, New Orleans, LA 70121 | 2020-04-22 |
| 1790255396 | Irianne Nicholas | Specialist/Technologist | 1201 South Clearview Parkway, Jefferson, LA 70121 | 2018-11-27 |
| 1225504889 | George Andrews | Orthopaedic Surgery | Ochsner Health System, 1514 Jefferson Highway, New Orleans, LA 70121 | 2018-10-22 |
| 1295213494 | Shima Abdulhameed A Aziz | Student in an Organized Health Care Education/Training Program | 1514 Jefferson Highway, Ochsner Clinic Foundation, New Orleans, LA 70121 | 2018-07-31 |
| 1396238721 | Treasure S Lucas | Case Manager/Care Coordinator | 827 Causeway Blvd Ste 206, Jefferson, LA 70121 | 2018-06-11 |
| 1396240909 | Jasmine Kaur Bahd | Student in an Organized Health Care Education/Training Program | 1401 Jefferson Highway, Academic Center 1st Floor, New Orleans, LA 70121 | 2018-03-26 |
| 1649774480 | William Shamus Rohn | Student in an Organized Health Care Education/Training Program | 137 Jules Ave, Jefferson, LA 70121 | 2018-03-19 |
| 1295262665 | Uday Shanker Nadimpally | Student in an Organized Health Care Education/Training Program | Ochsner Clinic Foundation, 1514, Jefferson Hwy, New Orleans, LA 70121 | 2017-05-17 |
| 1700324084 | Magnolia Community Services, Inc | Intermediate Care Facility, Mentally Retarded | 821 Jefferson Heights Ave., Jefferson, LA 70121 | 2017-02-07 |
| Find all providers in zip 70121 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417367137 | Parish Anesthesia of East New Orleans LLC | Pain Medicine | 5640 Read Blvd Ste 200, New Orleans, LA 70127-3126 | 2014-05-02 |
| 1316399512 | Healthspere Management Group, LLC | Pain Medicine | 4600 S Claiborne Ave, New Orleans, LA 70125-5010 | 2016-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487024527 | Dpi Pain Management LLC | Pain Medicine | 4727 W Park Dr, Suite B, Zachary, LA 70791-4090 | 2015-10-01 |
| 1033484340 | Michael Richard Voorhies Jr. | Pain Medicine | 605 Lapalco Blvd, Gretna, LA 70056-7302 | 2012-03-20 |
| 1720372311 | Advanced Pain Care and Wellness Center, LLC | Pain Medicine | 1234 Del Este Ave, Suite 201, Denham Springs, LA 70726-4828 | 2011-06-01 |
| 1740466440 | Ccp Medical Management, LLC | Pain Medicine | 213 Fourpark Rd, Suite C, Lafayette, LA 70507-2481 | 2008-01-14 |
| 1043259880 | Ihab J. Ibrahim | Pain Medicine | 672 Bert Kouns Industrial Loop, Shreveport, LA 71118-5701 | 2006-06-06 |
| 1427507656 | Msh Clinic | Pain Medicine | 105 Patriot St, Suite 101, Lafayette, LA 70508-6831 | 2016-09-29 |
| 1760856215 | La Pain Doctor Inc | Pain Medicine | 502 Rue De Sante, Suite 303, La Place, LA 70068-5424 | 2015-11-20 |
| 1265802748 | Frederick Bowers | Pain Medicine | 5408 Flanders Dr, Baton Rouge, LA 70808-9137 | 2015-09-28 |
| 1184895476 | Brian Michael Koch | Pain Medicine | 1111 Medical Center Blvd, Suite S750, Marrero, LA 70072-3151 | 2008-03-14 |
| 1306027438 | Russell T Stuermann | Pain Medicine | 2449 Hospital Dr Ste 300, Bossier City, LA 71111-1910 | 2007-11-16 |
| Find all providers with the same taxonomy | ||||
| City | NEW ORLEANS |
| Zip Code | 70121 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.