Provider Demographics
NPI:1659881720
Name:MYRON E MOOREHEAD MD APMC
Entity Type:Organization
Organization Name:MYRON E MOOREHEAD MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOOREHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-467-0770
Mailing Address - Street 1:200 W ESPLANADE AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-2474
Mailing Address - Country:US
Mailing Address - Phone:504-467-0770
Mailing Address - Fax:504-467-0971
Practice Address - Street 1:200 W ESPLANADE AVE STE 311
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2474
Practice Address - Country:US
Practice Address - Phone:504-467-0770
Practice Address - Fax:504-467-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty