Provider Demographics
NPI:1477643922
Name:HEARD, MICHEL EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:EDWARD
Last Name:HEARD
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 1:113 ST. THOMAS ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4554
Mailing Address - Country:US
Mailing Address - Phone:337-234-0898
Mailing Address - Fax:337-235-3081
Practice Address - Street 1:113 SAINT THOMAS ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4575
Practice Address - Country:US
Practice Address - Phone:337-234-0898
Practice Address - Fax:337-235-3081
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013797207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA013797OtherSTATE MEDICAL LICENSE
LA1312304Medicaid
LA013797OtherSTATE MEDICAL LICENSE
LAB89497Medicare UPIN