Provider Demographics
NPI:1790887677
Name:MINNARD, EMERY AUGUST (MD)
Entity Type:Individual
Prefix:
First Name:EMERY
Middle Name:AUGUST
Last Name:MINNARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 MEADOWCREST ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5255
Mailing Address - Country:US
Mailing Address - Phone:504-391-7660
Mailing Address - Fax:504-393-2407
Practice Address - Street 1:120 MEADOWCREST ST
Practice Address - Street 2:STE 450
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5255
Practice Address - Country:US
Practice Address - Phone:504-391-7660
Practice Address - Fax:504-393-2407
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
LA12291R2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF16886Medicare UPIN