Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | MD.011500 | LA |
NPI | 1346404670 |
---|---|
Provider Name | John W Megison |
First Address | Houma, LA 70363-7055 |
Second Address | Houma, LA 70363-7055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 09/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1138746 | (05) | LA |