Provider Demographics
NPI:1033678008
Name:MCWILLIAMS, MILES FELIX SR
Entity Type:Individual
Prefix:MR
First Name:MILES
Middle Name:FELIX
Last Name:MCWILLIAMS
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MILES
Other - Middle Name:FELIX
Other - Last Name:MCWILLIAMS
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8300 LOMOND RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2139
Mailing Address - Country:US
Mailing Address - Phone:504-473-1601
Mailing Address - Fax:504-252-9279
Practice Address - Street 1:8300 LOMOND RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-2139
Practice Address - Country:US
Practice Address - Phone:504-473-1601
Practice Address - Fax:504-252-9279
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver