Individual
MICHAEL BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
309722
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2017
Last updated
09/03/2020
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