Individual
DR. BOBBY L MIMELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4720 S I 10 SERVICE RD W, SUITE 301, METAIRIE, LA 70001-7404
(504) 885-8225
(504) 885-7642
Mailing address
4720 S I 10 SERVICE RD W, SUITE 301, METAIRIE, LA 70001-7404
(504) 885-8225
(504) 885-7642
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
011441
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00163179
MEDICARE RR
LA
Enumeration date
08/03/2005
Last updated
01/15/2008
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