Provider Demographics
NPI:1568565679
Name:TROTTER, MELVIN MAURICE (DPM,MS)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:MAURICE
Last Name:TROTTER
Suffix:
Gender:M
Credentials:DPM,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 GOODWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7744
Mailing Address - Country:US
Mailing Address - Phone:225-216-3338
Mailing Address - Fax:225-216-7175
Practice Address - Street 1:8333 GOODWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7744
Practice Address - Country:US
Practice Address - Phone:225-216-3338
Practice Address - Fax:225-216-3338
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD086R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1383996Medicaid
LAT35033Medicare UPIN
LA1383996Medicaid