Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 206080 | LA |
NPI | 1750588836 |
---|---|
Provider Name | Michael Heffernan |
First Address | New Orleans, LA 70118-5720 |
Second Address | New Orleans, LA 70118-5720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 20/03/2014 |