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Individual

DR. MYRON ERNEST MOOREHEAD II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 W ESPLANADE AVE, SUITE 311, KENNER, LA 70065-2474
(504) 467-0770
(504) 467-0791
Mailing address
200 W ESPLANADE AVE, SUITE 311, KENNER, LA 70065-2474
(504) 467-0770
(504) 467-0791

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MD4222R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
092522606
CONTROLLED SUBSTANCE LIC
LA
Enumeration date
11/29/2006
Last updated
09/20/2016
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