Provider Demographics
NPI:1851373872
Name:SAVOY, GREGORY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MICHAEL
Last Name:SAVOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 CAJUN DR
Mailing Address - Street 2:STE B
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2400
Mailing Address - Country:US
Mailing Address - Phone:337-468-5309
Mailing Address - Fax:337-468-3786
Practice Address - Street 1:1508 CAJUN DR
Practice Address - Street 2:STE B
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2400
Practice Address - Country:US
Practice Address - Phone:337-468-5309
Practice Address - Fax:337-468-3786
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010993174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1099805Medicaid
LA1099805Medicaid
LA55746Medicare ID - Type Unspecified