Provider Demographics
NPI:1508409467
Name:ANTOINE, MELANIE C (DO)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:C
Last Name:ANTOINE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 BERTRAND DR STE D5
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-9104
Mailing Address - Country:US
Mailing Address - Phone:337-349-7889
Mailing Address - Fax:
Practice Address - Street 1:102 SPRINGFIELD DR
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6016
Practice Address - Country:US
Practice Address - Phone:337-344-8831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty