Individual
DR. MELVIN MOKISO MURRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
4560 NORTH BLVD, SUITE 114, BATON ROUGE, LA 70806-4043
(225) 928-0695
(225) 928-3662
Mailing address
4560 NORTH BLVD, BATON ROUGE, LA 70806-4043
(225) 928-0695
(225) 928-3662
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
014291
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305561
—
LA
01
—
720923279
TAX IDENTIFICATION NUMBER
LA
Enumeration date
07/28/2006
Last updated
03/28/2014
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