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Individual

DR. DOUGLAS MEHAFFIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
148 WALL BLVD, GRETNA, LA 70056-7107
(504) 393-2775
(504) 393-2744
Mailing address
PO BOX 6039, NEW ORLEANS, LA 70174-6039
(504) 393-2775
(504) 393-2744

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024334
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1545929
LA
Enumeration date
06/01/2005
Last updated
04/23/2010
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