Provider Demographics
NPI:1235322074
Name:FRICKEY, LEIA A (MD)
Entity type:Individual
Prefix:
First Name:LEIA
Middle Name:A
Last Name:FRICKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 VETERANS BLVD
Mailing Address - Street 2:SUITE 275
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-455-7255
Mailing Address - Fax:504-455-7299
Practice Address - Street 1:3939 VETERANS BLVD
Practice Address - Street 2:SUITE 275
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-455-7255
Practice Address - Fax:504-455-7299
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.020845207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine