Provider Demographics
NPI:1790768729
Name:DAY, MICHAEL G (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:DAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13828 COURSEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-1307
Mailing Address - Country:US
Mailing Address - Phone:225-752-4530
Mailing Address - Fax:225-752-4652
Practice Address - Street 1:13828 COURSEY BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-1307
Practice Address - Country:US
Practice Address - Phone:225-752-4530
Practice Address - Fax:225-752-4652
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA023625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH23031Medicare UPIN
LA5H578CK50Medicare ID - Type Unspecified