Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | MD.202134 | LA |
NPI | 1083761944 |
---|---|
Provider Name | Dr. John Adam Flatt |
First Address | Covington, LA 70433-7237 |
Second Address | Covington, LA 70433-7237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 29/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1173231 | (05) | LA |