Metairie Total Wellness Clinic, LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

METAIRIE TOTAL WELLNESS CLINIC, LLC

Practice address

1813 Veterans Memorial Blvd Ste B
Metairie, LA 70005-2637

Phone

(800) 246-5698

NPI assigned

May 7, 2018

Organization subpart

Yes

Parent organization

MODERN MALE T-CLINIC, P.A.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Salvatore Campo, DO

Title

DO / Physician

Phone

(214) 714-5343

Specialties & licenses 2

Addresses

Part of

Modern Male T-Clinic PA

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1356830251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 ELDORADO PKWY STE 150-153",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750338695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 VETERANS MEMORIAL BLVD STE B",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700052637",
            "telephone_number": "800-246-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAIRIE TOTAL WELLNESS CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MODERN MALE T-CLINIC, P.A.",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "CAMPO",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_title_or_position": "DO / PHYSICIAN",
        "authorized_official_telephone_number": "214-714-5343",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Metairie, LA
• Providers in Metairie, LA by specialty
• Adult Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.