Organization
MEDA COLVIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEDA KAYE COLVIN MD (MANAGER/DOCTOR)
(504) 319-8578
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER BLVD., SUITE SOUTH 555, MARRERO, LA 70072-0000
(504) 934-8110
(504) 934-8188
Mailing address
1111 MEDICAL CENTER BLVD., SUITE SOUTH 555, MARRERO, LA 70072-0000
(504) 934-8110
(504) 934-8188
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD019520
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1976938
—
LA
Enumeration date
08/24/2009
Last updated
07/15/2011
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