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Individual

MR. DAVID TAGGART GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
2880 HIGHWAY 190, MANDEVILLE, LA 70471-3254
(985) 624-8548
Mailing address
2880 HIGHWAY 190, MANDEVILLE, LA 70471-3254
(985) 624-8548
(985) 624-4872

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
14380
LA
183500000X
Pharmacist
Primary
PST.014380
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1894656
LA
Enumeration date
07/18/2007
Last updated
12/20/2022
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