| Michelle M. Davis, Llc | |
|
200 W Esplanade Ave Suite 106 Kenner LA 70065-2489 | |
| (504) 712-7000 | |
| (504) 712-7040 |
| Full Name | Michelle M. Davis, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 200 W Esplanade Ave, Kenner, Louisiana |
| Authorized Official Name and Position | Michelle Mireille Davis (PHYSICIAN) |
| Authorized Official Contact | 5047127000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle M. Davis, Llc 200 W Esplanade Ave Suite 106 Kenner LA 70065-2489 Ph: (504) 712-7000 | Michelle M. Davis, Llc 200 W Esplanade Ave Suite 106 Kenner LA 70065-2489 Ph: (504) 712-7000 |
| NPI Number | 1760504120 |
|---|---|
| Provider Enumeration Date | 04/05/2007 |
| Last Update Date | 05/09/2008 |
| Medicare PECOS PAC ID | 1557302668 |
|---|---|
| Medicare Enrollment ID | O20050519000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760504120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14461R (Louisiana) | Primary |
| Provider Name | Michelle Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104898576 PECOS PAC ID: 4486639440 Enrollment ID: I20040623000278 |
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