Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 10302 | LA |
NPI | 1598891806 |
---|---|
Provider Name | Dr. David Malcom Doan |
First Address | Hammond, LA 70404-2459 |
Second Address | Hammond, LA 70403-1453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 05/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1132314 | (05) | LA |
B63063 | (02) | LA |