Individual
DR. JOHN JOSEPH MICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 HOSPITAL DR, LAFAYETTE, LA 70503-2819
(337) 232-2900
(337) 232-2990
Mailing address
110 HOSPITAL DR, LAFAYETTE, LA 70503-2819
(337) 232-2900
(337) 232-2990
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
14418
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1193411
—
LA
01
—
60054546
RR MEDICARE
LA
Enumeration date
08/09/2005
Last updated
09/11/2007
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