Provider Demographics
NPI:1497931687
Name:CUMMINGS, MICHAEL ALAN (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 4162
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361
Mailing Address - Country:US
Mailing Address - Phone:985-851-3680
Mailing Address - Fax:985-876-3074
Practice Address - Street 1:5953 WEST PARK AVENUE
Practice Address - Street 2:SUITE 3000
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364
Practice Address - Country:US
Practice Address - Phone:985-851-3680
Practice Address - Fax:985-876-3074
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1539571T152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management