Organization
MICHAEL R MELANCON, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL RAY MELANCON M.D. (OWNER)
(337) 989-8080
Entity
Organization
Contact information
Practice address
4650 AMBASSADOR CAFFERY PKWY, SUITE 105, LAFAYETTE, LA 70508-6926
(337) 989-8080
(337) 981-0913
Mailing address
4650 AMBASSADOR CAFFERY PKWY, SUITE 105, LAFAYETTE, LA 70508-6926
(337) 989-8080
(337) 981-0913
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
015178
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1324833
—
LA
Enumeration date
05/08/2012
Last updated
05/08/2012
Update your record
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