Kenneth Marlin Dieffenbach, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

03064R Issued in LA

Practice address

Lsu Plastic Surgery Clinic
1532 Tulane Avenue
New Orleans, LA 70112

Phone

(504) 903-2917

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760405682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 POYDRAS ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701121221",
            "telephone_number": "504-412-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LSU PLASTIC SURGERY CLINIC",
            "address_2": "1532 TULANE AVENUE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-903-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEFFENBACH",
        "first_name": "KENNETH",
        "middle_name": "MARLIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "03064R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1143987",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hillary Guidry Dickinson, FNP
• Laura Dickinson, LCSW
• Amy Brooke Dickson, PSY D
• William Nolan Dickson
• Erin H. Diebold, PA
• Anelise Katherine Diener, DO
• Ross Michael Dies
• Christopher Lane Diethelm
• Nancy Elizabeth Diethelm, MD
• Kathleen Dietrich, BCBA

• Cardiovascular Disease Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Cardiovascular Disease Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.