# THOMAS P MELANCON MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154650679
- **Authorized official:** DR. THOMAS P MELANCON MD (PRESIDENT)
- **Authorized official phone:** (504) 392-7999

## Contact information

- **Practice address:** 1111 MEDICAL CENTER BLVD, SUITE 205, MARRERO, LA 70072-3151
- **Practice address phone:** (504) 392-7999
- **Practice address fax:** (504) 392-6100
- **Mailing address:** 1111 MEDICAL CENTER BLVD, SUITE 205, MARRERO, LA 70072-3151
- **Mailing address phone:** (504) 392-7999
- **Mailing address fax:** (504) 392-6100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 18656 | LA | Yes |

## Other

- **Enumeration date:** 12/11/2009
- **Last updated:** 08/25/2010