Provider Demographics
NPI:1487615142
Name:JULEFF, RANDALL SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:SCOTT
Last Name:JULEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1431 OCHSNER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8110
Mailing Address - Country:US
Mailing Address - Phone:985-892-2950
Mailing Address - Fax:985-892-2980
Practice Address - Street 1:4080 LONESOME RD STE A
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-7093
Practice Address - Country:US
Practice Address - Phone:985-892-2950
Practice Address - Fax:985-892-2980
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09083R208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1660043Medicaid
LA780002322Medicare PIN
LA1660043Medicaid
LA5W074CE57Medicare PIN