Individual
CHARLES DANIEL MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1103 KALISTE SALOOM ROAD, SUITE 102, LAFAYETTE, LA 70508-2636
(337) 234-5234
(337) 235-2121
Mailing address
1103 KALISTE SALOOM ROAD, SUITE 102, LAFAYETTE, LA 70508-2636
(337) 234-5234
(337) 235-2121
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
A10616
LA
Other
Enumeration date
07/28/2005
Last updated
02/05/2009
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