Individual
SCOTT THOMAS MICHAELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 MEDICAL CENTER DRIVE, SLIDELL, LA 70461-5520
(985) 646-5189
(661) 326-8022
Mailing address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
(661) 326-8022
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A9823
CA
207P00000X
Emergency Medicine Physician
Primary
D0.000255
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07888299
—
MS
05
—
2160109
—
LA
Enumeration date
04/07/2008
Last updated
11/03/2011
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