Individual
MICHAEL D FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
424 W MCNEESE ST, LAKE CHARLES, LA 70605-5547
(337) 478-0511
(337) 478-5644
Mailing address
424 W MCNEESE ST, LAKE CHARLES, LA 70605-5547
(337) 478-0511
(337) 478-5644
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN085525
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1563021
—
LA
01
—
430054687
RAILROAD MEDICARE PIN
LA
Enumeration date
01/24/2006
Last updated
06/03/2022
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