Provider Demographics
NPI:1730321399
Name:CROCHET, MEGAN ALDEN (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ALDEN
Last Name:CROCHET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ALDEN
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1231 PRYTANIA ST STE 600
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-4559
Mailing Address - Country:US
Mailing Address - Phone:504-300-9407
Mailing Address - Fax:504-437-1625
Practice Address - Street 1:1231 PRYTANIA ST STE 600
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-4559
Practice Address - Country:US
Practice Address - Phone:504-300-9407
Practice Address - Fax:504-437-1625
Is Sole Proprietor?:No
Enumeration Date:2009-03-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD2057422084P0800X
LA2057422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00979332Medicaid
LA2192981Medicaid
LA2192981Medicaid