| Thomas P Melancon Md Llc | |
|
1111 Medical Center Blvd Suite 205 Marrero LA 70072-3151 | |
| (504) 392-7999 | |
| (504) 392-6100 |
| Full Name | Thomas P Melancon Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 Medical Center Blvd, Marrero, Louisiana |
| Authorized Official Name and Position | Thomas P Melancon (PRESIDENT) |
| Authorized Official Contact | 5043927999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas P Melancon Md Llc 1111 Medical Center Blvd Suite 205 Marrero LA 70072-3151 Ph: (504) 392-7999 | Thomas P Melancon Md Llc 1111 Medical Center Blvd Suite 205 Marrero LA 70072-3151 Ph: (504) 392-7999 |
| NPI Number | 1154650679 |
|---|---|
| Provider Enumeration Date | 12/11/2009 |
| Last Update Date | 08/25/2010 |
| Medicare PECOS PAC ID | 7214070184 |
|---|---|
| Medicare Enrollment ID | O20100202000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154650679 | NPI | - | NPPES |
| 1397610 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18656 (Louisiana) | Primary |
| Provider Name | Thomas Melancon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811989197 PECOS PAC ID: 9133262009 Enrollment ID: I20100202000073 |
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