Provider Demographics
NPI:1720161839
Name:MOMPOINT, DANIEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:MOMPOINT
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 1:230 MEADOWCREST ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5246
Mailing Address - Country:US
Mailing Address - Phone:504-392-5997
Mailing Address - Fax:504-394-3723
Practice Address - Street 1:230 MEADOWCREST ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5246
Practice Address - Country:US
Practice Address - Phone:504-392-5997
Practice Address - Fax:504-392-3723
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07579R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA79244OtherBLUE CROSS ID
LA721157696OtherCOMMERICAL INSURANCE COMP
LA721157696OtherTRICARE REGIONS 3&4
LA1357144Medicaid
LA721157696OtherTAX ID NUMBER
LA721157696OtherTRICARE REGIONS 3&4
LA54329Medicare ID - Type UnspecifiedMEDICARE ID #