Provider Demographics
NPI:1770592453
Name:MICHAEL R KAYE LLC
Entity type:Organization
Organization Name:MICHAEL R KAYE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:985-892-7206
Mailing Address - Street 1:PO BOX 1423
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-1423
Mailing Address - Country:US
Mailing Address - Phone:985-892-7206
Mailing Address - Fax:985-892-9990
Practice Address - Street 1:101 E FAIRWAY DR
Practice Address - Street 2:SUITE 206
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7503
Practice Address - Country:US
Practice Address - Phone:985-893-3320
Practice Address - Fax:985-893-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5487230001OtherPCAN
5CR26Medicare ID - Type Unspecified