Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 20495 | LA |
NPI | 1316026560 |
---|---|
Provider Name | Dr. John David Mccain |
First Address | Houma, LA 70360-2462 |
Second Address | Houma, LA 70360-2462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 03/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1900788 | (05) | LA |
E98667 | (02) |