Provider Demographics
NPI:1164410569
Name:FRIERSON, MICHAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:FRIERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 HENNESSY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4384
Mailing Address - Country:US
Mailing Address - Phone:225-765-6453
Mailing Address - Fax:225-768-2424
Practice Address - Street 1:7301 HENNESSY
Practice Address - Street 2:SUITE 200
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-765-6453
Practice Address - Fax:225-768-2424
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09808R207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200040905OtherRAILROAD MEDICARE
LA1969354Medicaid
MS06529799Medicaid
LA5R748BD11Medicare PIN
5R748Medicare ID - Type Unspecified
MS06529799Medicaid