Individual
DR. THOMAS P MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE 205, MARRERO, LA 70072-3151
(504) 392-7999
(504) 392-6100
Mailing address
1111 MEDICAL CENTER BLVD, SUITE 205, MARRERO, LA 70072-3151
(504) 392-7999
(504) 392-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18656
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110208321
RAILROAD MEDICARE
LA
05
—
1397610
—
LA
01
—
80752
AETNA
LA
01
—
F7245
BLUE CROSS
LA
Enumeration date
08/22/2005
Last updated
08/25/2010
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